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Minosse S, Picchi E, Ferrazzoli V, Pucci N, Da Ros V, Giocondo R, Floris R, Garaci F, Di Giuliano F. Influence of scan duration on dynamic contrast -enhanced magnetic resonance imaging pharmacokinetic parameters for brain lesions. Magn Reson Imaging 2024; 105:46-56. [PMID: 37939968 DOI: 10.1016/j.mri.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Gadolinium-based contrast agent needs time to leak into the extravascular-extracellular space, leak back into the vascular space, and reach an equilibrium state. For this reason, acquisition times of <10 min may cause inaccurate estimation of pharmacokinetic parameters. Since no studies have been conducted on the influence of long scan times on DCE-MRI parameters in brain tumors, the aim of this study is to investigate the variation of DCE-MRI-derived kinetic parameters as a function of acquisition time, from 5 to 10 min in brain tumors. MATERIALS AND METHODS Fifty-two patients with histologically confirmed brain tumors were enrolled in this retrospective study, and examination at 3 T, DCE-MRI, with scan duration of 10 min, was used for retrospective generation of 6 sets of quantitative DCE-MRI maps (Ktrans, Ve and Kep) from 5 to 10 min. Features were extracted from the DCE-MRI maps in contrast enhancement (CE) volumes. Kruskal-Wallis with post-hoc correction and coefficient of variation (CoV) were used as statistical test to compare DCE-MRI maps obtained from 6 data sets. SIGNIFICANCE p < 0.05. RESULTS No differences in Ktrans features in CE volumes between different scan durations. Ve, Kep features in CE volumes were influenced by different data length. The highest number of significantly different Ve and Kep features in CE volumes were between 5 min and 10 min (p < 0.013), 5 min and 9 min (p < 0.044), 6 min and 10 min (p < 0.040). CoV of Kep was reduced from 5 min to 10 min, going from highly variable (CoV = 0.70) to mildly variable (CoV = 0.42). CONCLUSION Kep and Ve were time-dependent in brain tumors, so a longer scan time is needed to obtain reliable parameter values. Ktrans was found to be time-independent, as it remains the same in all 6 acquisition times and is the only reliable parameter with short acquisition times.
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Affiliation(s)
- Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy.
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Valerio Da Ros
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Raffaella Giocondo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy; San Raffaele Cassino, Via Gaetano di Biasio 1, Cassino 03043, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
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2
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Minosse S, Picchi E, Conti A, di Giuliano F, di Ciò F, Sarmati L, Teti E, de Santis S, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Multishell diffusion MRI reveals whole-brain white matter changes in HIV. Hum Brain Mapp 2023; 44:5113-5124. [PMID: 37647214 PMCID: PMC10502617 DOI: 10.1002/hbm.26448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 07/15/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023] Open
Abstract
Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) have been previously used to explore white matter related to human immunodeficiency virus (HIV) infection. While DTI and DKI suffer from low specificity, the Combined Hindered and Restricted Model of Diffusion (CHARMED) provides additional microstructural specificity. We used these three models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. While significant group effects were found in all diffusion metrics, CHARMED and DKI analyses uncovered wider involvement (80% vs. 20%) of all white matter tracts in HIV infection compared with DTI. In restricted fraction (FR) analysis, we found significant differences in the left corticospinal tract, middle cerebellar peduncle, right inferior cerebellar peduncle, right corticospinal tract, splenium of the corpus callosum, left superior cerebellar peduncle, left superior cerebellar peduncle, pontine crossing tract, left posterior limb of the internal capsule, and left/right medial lemniscus. These are involved in language, motor, equilibrium, behavior, and proprioception, supporting the functional integration that is frequently impaired in HIV-positivity. Additionally, we employed a machine learning algorithm (XGBoost) to discriminate HIV-positive patients from healthy controls using DTI and CHARMED metrics on an ROIwise basis, and unique contributions to this discrimination were examined using Shapley Explanation values. The CHARMED and DKI estimates produced the best performance. Our results suggest that biophysical multishell imaging, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.
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Affiliation(s)
- Silvia Minosse
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
| | - Eliseo Picchi
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Allegra Conti
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesca di Giuliano
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Francesco di Ciò
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Loredana Sarmati
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Elisabetta Teti
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Silvia de Santis
- Instituto de NeurocienciasConsejo Superior de Investigaciones Científicas and Universidad Miguel HernándezSant Joan d'AlacantSpain
| | - Massimo Andreoni
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Roberto Floris
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Maria Guerrisi
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesco Garaci
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- IRCSS San Raffaele CassinoFrosinoneItaly
| | - Nicola Toschi
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Athinoula A. Martinos Center for Biomedical ImagingHarvard Medical SchoolBostonMassachusettsUSA
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3
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Picchi E, Leomanni P, Dell'Olio VB, Pucci N, Di Giuliano F, Ferrazzoli V, Minosse S, Rho M, Chiocchi M, Garaci F, Floris R. Triple gallbladder: radiological review. Clin J Gastroenterol 2023; 16:629-640. [PMID: 37563490 PMCID: PMC10539416 DOI: 10.1007/s12328-023-01829-3] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/01/2023] [Indexed: 08/12/2023]
Abstract
Triple gallbladder represents a rare congenital anatomical abnormality that can be a diagnostic challenge in reason to its rarity and consequential difficulties with diagnosis and identification. A systematic review of all published literature between 1958 and 2022 was performed. We identified 20 previous studies that provided 20 cases of triple gallbladder; our case was also included in the analysis, making a total of 21 patients. All patients underwent on diagnostic imaging examinations. After 1985, 9 patients underwent US examination which allowed prompt recognition of triple gallbladder in 2 patients only. CT was performed in 3 patients and allowed the correct diagnosis in a case. In 4 patients, was performed MRCP which allowed the correct diagnosis of triple gallbladder in all patients. Preoperative imaging allows the recognition of triple gallbladder in 9 of 21 patients (43%); in 12 patients (57%) the diagnosis was intraoperative. On patients considered, 16/21 underwent cholecystectomy. In 15 cases, the excised gallbladders were submitted for histopathological characterization with detection of metaplasia of the mucosa in 3 patients, while papillary adenocarcinoma was found in one. Imaging plays a key role in the identification of the anatomical variants of gallbladder, especially triple gallbladder, as modern imaging techniques allow a detailed assessment of the course of the biliary tract for a correct preoperative diagnosis. It is also crucial to be aware of the association between this condition and the metaplasia phenomena with the development of adenocarcinoma, as this may influence the patient's course of treatment.
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Affiliation(s)
- Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
| | - Paola Leomanni
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Vito Bruno Dell'Olio
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Di Giuliano
- Department of Biomedicine and Prevention, Neuroradiology Unit, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Ferrazzoli
- Department of Biomedicine and Prevention, Neuroradiology Unit, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Maurizio Rho
- Department of Surgical Science, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Marcello Chiocchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, Neuroradiology Unit, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
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4
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Chiocchi M, Luciano A, De Stasio V, Pugliese L, Picchi E, Di Donna C, Volpe M, Pitaro M, Garaci F, Floris R. Cardiac lipoma of the interventricular septum presenting with chest pain. Radiol Case Rep 2023; 18:1886-1889. [PMID: 36936801 PMCID: PMC10020461 DOI: 10.1016/j.radcr.2023.02.003] [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: 11/27/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 03/11/2023] Open
Abstract
In this case report, we describe an incidental finding of interventricular septum lipoma in a 55-year-old man who came to our attention for chest pain. The ECG showed no changes compatible with ongoing ischemia. While laboratory tests documented increased troponin levels with normal D-dimer levels. Due to the technical difficulties encountered during the performance of the transthoracic echocardiogram, a cardiac CT scan was requested, which ruled out significant coronary artery disease and acute aortic syndromes and showed the presence of a circumscribed fat-dense mass located in the basal portion of the interventricular septum. Subsequent cardiac MRI confirmed the diagnosis of lipoma of the interventricular septum.
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5
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Bovenzi R, Sancesario GM, Conti M, Grillo P, Cerroni R, Bissacco J, Forti P, Giannella E, Pieri M, Minosse S, Ferrazzoli V, Pucci N, Laudazi M, Floris R, Garaci F, Pierantozzi M, Stefani A, Mercuri NB, Picchi E, Di Giuliano F, Schirinzi T. Sex hormones differentially contribute to Parkinson's disease in males: a multimodal biomarker study. Eur J Neurol 2023. [PMID: 36971787 DOI: 10.1111/ene.15801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND AND PURPOSE Parkinson disease (PD) presents relevant sex-related differences in epidemiology, pathophysiology, and clinical features, with males being more vulnerable to the disease. Sex hormones might have a role, as the experimental models suggest; however, human-based evidence is scarce. Here, we integrated multimodal biomarkers to investigate the relationships between circulating sex hormones and clinical-pathological features in male PD patients. METHODS A cohort of 63 male PD patients underwent comprehensive clinical evaluation of motor and nonmotor disturbances; measurement of estradiol, testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) blood levels; and cerebrospinal fluid (CSF) assay of total α-synuclein, amyloid-β-42, amyloid-β-40, total tau, and phosphorylated-181 tau levels. A subgroup of 47 PD patients underwent brain volumetry by 3-T magnetic resonance imaging for further correlations. A control group of 56 age-matched individuals was enrolled for comparative analyses. RESULTS Male PD patients had higher estradiol and testosterone levels than controls. Estradiol had independent inverse associations with Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part 3 score and disease duration; it was also lower in nonfluctuating patients. Testosterone had inverse independent correlations with CSF α-synuclein and right globus pallidus volume. FSH and LH had age-dependent correlations with cognitive impairment and CSF amyloid-β-42/amyloid-β-40 ratio. CONCLUSIONS The study suggested that sex hormones could differentially contribute to clinical-pathological features of PD in male patients. Whereas estradiol might have a protective role in motor impairment, testosterone might be involved in male vulnerability to PD neuropathology. Gonadotropins instead might mediate age-dependent phenomena of amyloidopathy and cognitive decline.
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Affiliation(s)
- Roberta Bovenzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Matteo Conti
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Piergiorgio Grillo
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Rocco Cerroni
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Jacopo Bissacco
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Paolo Forti
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Emilia Giannella
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Clinical Biochemistry, Tor Vergata University Hospital, Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Mario Laudazi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- San Raffaele Cassino, Cassino, Italy
| | - Mariangela Pierantozzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandro Stefani
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Parkinson Centre Unit, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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6
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Ferrazzoli V, Picchi E, Pitocchi F, Vattermoli L, Pucci N, Di Giuliano F, Wlderk A, Bagnato MR, Da Ros V, Garaci F, Floris R. Bithalamic infarction in a tentorial dural artero-venous fistula and thalamic dementia: a case report and systematic review. Neurol Sci 2023:10.1007/s10072-023-06716-w. [PMID: 36932275 DOI: 10.1007/s10072-023-06716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 02/06/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE To report a case of bilateral thalamic infarction (BTI) presenting as progressive thalamic dementia due to a midline tentorial dAVF (TdAVF) and to provide a systematic review of the literature. METHODS We performed a systematic literature review of previously reported cases of bi-thalamic signal changes due to dAVF considering population characteristics, clinical presentation, imaging findings, treatments, and outcomes. RESULTS We found 29 papers from 1985 until 2021 describing 35 cases of BTI dAVF-related. We analysed 36 cases comprehensive of our case report. The mean age was 58.7 years (range 38-79), 91.6% were males (n=33). Most cases presented with a subacute syndrome. In 86.1% (n=31) of cases a TdAVF was found; 58.3% (n=21) were type 2 Borden-Shucart fistulas, the remaining were mostly type 3. In 80.5% (n=29), a thrombosed sinus was identified. 33.3% of cases (n=12) had bi-thalamic haemorrhages. Endovascular treatment was performed in 83.3% of cases (n=30). A total of 75% (n=27) of cases had a good recovery. CONCLUSIONS BTIs due to dAVFs may present with subacute symptoms overlapping with several differential diagnoses. Prompt identification at MRI, before venous drainage failure and bleeding, is crucial for a good prognosis.
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Affiliation(s)
- Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Eliseo Picchi
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Pitocchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Leonardo Vattermoli
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Andrea Wlderk
- Interventional Neuroradiology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Maria Rosaria Bagnato
- Neurology Unit, Department of Neurology, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Valerio Da Ros
- Interventional Neuroradiology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Floris
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
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7
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Di Giuliano F, Picchi E, Pucci N, Minosse S, Ferrazzoli V, Pizzicannella G, Angeloni C, Nasso D, Chiaravalloti A, Garaci F, Floris R. Comparison between diffusion-weighted magnetic resonance and positron-emission tomography in the evaluation of treated lymphomas with mediastinal involvement. Egypt J Radiol Nucl Med 2022. [DOI: 10.1186/s43055-022-00825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The persistence of residual tissue after treatment is frequent in patients with mediastinal lymphomas and it is often characterized by 18F-Flurodeoxyglucose Positron Emission Tomography (18F-FDG PET) uptake. This study aims to investigate the usefulness of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) sequence in residual tissues of treated mediastinal lymphomas and to compare it with 18F-FDG PET-CT.
Results
We included 21 patients with mediastinal Hodgkin and non-Hodgkin lymphomas who showed residual masses on PET-CT imaging at end of treatment and underwent DWIBS-Magnetic Resonance Imaging (MRI). SUVmax and Apparent Diffusion Coefficient (ADC) values of residual masses were assessed quantitatively, including measurement of mean ADC. 15 patients showed radiotracer uptake at 18F-FDG PET-CT, among them only 3 had positive DWIBS-MRI with low ADC values (median value: 0.90 mm2/s). The mediastinal biopsy in these 3 “double positive” patients confirmed pathological residual tissue. All the patients with positive 18F-FDG PET-CT but negative DWIBS-MRI (n = 18) with high ADC values (median value: 2.05 mm2/s) were confirmed negative by biopsy.
Conclusions
DWIBS-MRI examination combined with ADC measurement allowed to discriminate pathological and non-pathological residual tissue in patients with treated mediastinal lymphoma. These preliminary results seem to pave the way for a leading role of the MRI which could be a useful alternative to the 18F-FDG PET/CT.
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Giuliano FD, Perretta T, Pitocchi F, Pucci N, Serio ML, Caliandro A, Picchi E, Ferrazzoli V, Pistolese CA, Garaci F, Floris R. Coexistence of primary central nervous system lymphoma and primary breast lymphoma: Clinical presentation, imaging features, and treatment management. Radiol Case Rep 2022; 17:2470-2476. [PMID: 35586158 PMCID: PMC9108739 DOI: 10.1016/j.radcr.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/02/2022] [Accepted: 04/05/2022] [Indexed: 11/19/2022] Open
Abstract
The presence of synchronous dual hematological diseases is an uncommon finding. We report an unusual case of coexistence of primary central nervous system lymphoma and primary breast lymphoma without systemic involvement in an immunocompetent patient. To our knowledge a similar case has not yet been reported in the literature. We especially focus on presenting the imaging features, the associated clinical findings and treatment management of each entity, with the aim of raising awareness on these two rare types of lymphomas and the possibility of their coexistence.
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Affiliation(s)
- Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Tommaso Perretta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Francesca Pitocchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Noemi Pucci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
- Corresponding author.
| | - Maria Lina Serio
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Aurelia Caliandro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Chiara Adriana Pistolese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome, 00133, Italy
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Minosse S, Picchi E, Giuliano FD, di Cio F, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Compartmental models for diffusion weighted MRI reveal widespread brain changes in HIV-infected patients. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:3834-3837. [PMID: 34892070 DOI: 10.1109/embc46164.2021.9629510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Diffusion tensor imaging (DTI) has been used to explore changes in the brain of subjects with human immunodeficiency virus (HIV) infection. However, DTI notoriously suffers from low specificity. Neurite orientation dispersion and density imaging (NODDI) is a compartmental model able to provide specific microstructural information with additional sensitivity/specificity. In this study we use both the NODDI and the DTI models to evaluate microstructural differences between 35 HIV-positive patients and 20 healthy controls. Diffusion-weighted imaging was acquired using three b-values (0, 1000 and 2500 s/mm2). Both DTI and NODDI models were fitted to the data, obtaining estimates for fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), neurite density index (NDI) and orientation dispersion index (ODI), after which we performed group comparisons using Tract-based spatial statistics (TBSS). While significant group effects were found in in FA, MD, RD, AD and NDI, NDI analysis uncovered a much wider involvement of brain tissue in HIV infection as compared to DTI. In region-of interest (ROI)-based analysis, NDI estimates from the right corticospinal tract produced excellent performance in discriminating the two groups (AUC = 0.974, sensitivity = 90%; specificity =97%).
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Di Cio F, Minosse S, Picchi E, Di Giuliano F, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Whole-brain white matter network reorganization in HIV. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:3830-3833. [PMID: 34892069 DOI: 10.1109/embc46164.2021.9629503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The human immunodeficiency virus (HIV) causes an infectious disease with a high viral tropism toward CD4 T-lymphocytes and macrophage. Since the advent of combined antiretroviral therapy (CART), the number of opportunistic infectious disease has diminished, turning HIV into a chronic condition. Nevertheless, HIV-infected patients suffer from several life-long symptoms, including the HIV-associated neurocognitive disorder (HAND), whose biological substrates remain unclear. HAND includes a range of cognitive impairments which have a huge impact on daily patient life. The aim of this study was to examine putative structural brain network changes in HIV-infected patient to test whether diffusion-imaging-related biomarkers could be used to discover and characterize subtle neurological alterations in HIV infection. To this end, we employed multi-shell, multi-tissue constrained spherical deconvolution in conjunction with probabilistic tractography and graph-theoretical analyses. We found several statistically significant effects in both local (right postcentral gyrus, right precuneus, right inferior parietal lobule, right transverse temporal gyrus, right inferior temporal gyrus, right putamen and right pallidum) and global graph-theoretical measures (global clustering coefficient, global efficiency and transitivity). Our study highlights a global and local reorganization of the structural connectome which support the possible application of graph theory to detect subtle alteration of brain regions in HIV patients.Clinical Relevance-Brain measures able to detect subtle alteration in HIV patients could also be used in e.g. evaluating therapeutic responses, hence empowering clinical trials.
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Minosse S, Garaci F, Martino F, Di Mauro R, Melis M, Di Giuliano F, Picchi E, Guerrisi M, Floris R, Di Girolamo S, Toschi N. Global and local brain connectivity changes associated with sudden unilateral sensorineural hearing loss. NMR Biomed 2021; 34:e4544. [PMID: 34046962 DOI: 10.1002/nbm.4544] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
Recent studies suggest that even moderate sudden sensorineural hearing loss (SSNHL) causes reduction of gray matter volume in the primary auditory cortex, diminishing its ability to react to sound stimulation, as well as reorganization of functional brain networks. We employed resting-state functional MRI (rs-fMRI), in conjunction with graph-theoretical analysis and a newly developed functional "disruption index," to study whole-brain as well as local functional changes in patients with unilateral SSNHL. We also assessed the potential of graph-theoretical measures as biomarkers of disease, in terms of their relationship to clinically relevant audiological parameters. Eight patients with moderate or severe unilateral SSNHL and 15 healthy controls were included in this prospective pilot study. All patients underwent rs-fMRI to study potential changes in brain connectivity. From rs-fMRI data, global and local graph-theoretical measures, disruption index, and audiological examinations were estimated. Mann-Whitney U tests were used to study the differences between SSNHL patients and healthy controls. Associations between brain metrics and clinical variables were studied using multiple linear regressions, and the presence or absence of brain network hubs was assessed using Fisher's exact test. No statistically significant differences between SSNHL patients and healthy controls were found in global or local network measures. However, when analyzing brain networks through the disruption index, we found a brain-wide functional network reorganization (p < 0.001 as compared with controls), whose extent was associated with clinical impairment (p < 0.05). We also observed several functional hubs in SSNHL patients that were not present in healthy controls and vice versa. Our results demonstrate a brain involvement in SSNHL patients, not detectable using conventional graph-theoretical analysis, which may yield subtle disease clues and possibly aid in monitoring disease progression in clinical trials.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
- San Raffaele Cassino, Cassino, Frosinone, Italy
| | - Federica Martino
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Roberta Di Mauro
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
- Neuroscience Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Milena Melis
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Stefano Di Girolamo
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts
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Di Giuliano F, Minosse S, Picchi E, Ferrazzoli V, Da Ros V, Muto M, Pistolese CA, Garaci F, Floris R. Qualitative and quantitative analysis of 3D T1 Silent imaging. Radiol Med 2021; 126:1207-1215. [PMID: 34131844 DOI: 10.1007/s11547-021-01380-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/20/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To compare brain magnetic resonance imaging (MRI) using T1 3D Silent and fast T1 3D Gradient-Echo (GRE) BRAin VOlume (known as BRAVO) sequences. The primary aim is to assess the quantitative and qualitative analysis of Silent and BRAVO images by the measurement of the contrast (C), the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). The second aim is to estimate the subjective sound levels and the specific absorption rate (SAR). METHODS Twenty-two subjects had T1 3D Silent and T1 3D BRAVO sequences added to the standard MR examination. The qualitative analysis of the two sequences was performed by two radiologists independently. The quantitative analysis was performed by placing regions of interest on the cerebrospinal fluid, on the white and grey matter. The C, the CNR and the SNR were calculated for each sequence. After each T1-3D sequence, subjects gave a score rating to evaluate the acoustic noise. Finally, the SAR was evaluated by the digital imaging and communications in medicine (DICOM) tags. RESULTS The image quality scores obtained by the two radiologists were higher for BRAVO compared to the Silent. However, qualitatively, the Silent images were similar to BRAVO for diagnostic use. Quantitatively, CNR for GM-CSF was comparable in the two sequences and SNR in CSF was higher in Silent than BRAVO. The acoustic noise of Silent sequence was statistically lower compared with BRAVO. The maximum SAR measured was 1.4 W/kg. CONCLUSIONS 3D T1 Silent can be a valid alternative technique to conventional BRAVO to reduce the acoustic noise preserving the diagnostic accuracy. However, radiologists preferred the conventional sequence to Silent.
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Affiliation(s)
- Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy.
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Valerio Da Ros
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Massimo Muto
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80100, Naples, Italy
| | - Chiara Adriana Pistolese
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- San Raffaele Cassino, Cassino, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
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Minosse S, Picchi E, Di Giuliano F, Sarmati L, Teti E, Pistolese CA, Lanzafame S, Di Ciò F, Guerrisi M, Andreoni M, Floris R, Toschi N, Garaci F. Functional brain network reorganization in HIV infection. J Neuroimaging 2021; 31:796-808. [PMID: 33900655 DOI: 10.1111/jon.12861] [Citation(s) in RCA: 5] [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] [Received: 12/17/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND PURPOSE To investigate the reorganization of the central nervous system provided by resting state-functional MRI (rs-fMRI), graph-theoretical analysis, and a newly developed functional brain network disruption index in patients with human immunodeficiency virus (HIV) infection. METHODS Forty HIV-positive patients without neurological impairment and 20 age- and sex-matched healthy controls underwent rs-fMRI at 3T; blood sampling was obtained the same day to evaluate biochemical variables (absolute, relative, and nadir CD4 T-lymphocytes value and plasmatic HIV-RNA). From fMRI data, disruption indices, as well as global and local graph theoretical measures, were estimated and examined for group differences (HIV vs. controls) as well as for associations with biochemical variables (HIV only). Finally, all data (global and local graph-theoretical measures, disruption indices, and biochemical variables) were tested for putative differences across three patient groups based on the duration of combined antiretroviral therapy (cART). RESULTS Brain function of HIV patients appeared to be deeply reorganized as compared to normal controls. The disruption index showed significant negative association with relative CD4 values, and a positive significant association between plasmatic HIV-RNA and local graph-theoretical metrics in the left lingual gyrus and the right lobule IV and V of right cerebellar hemisphere was also observed. Finally, a differential distribution of HIV clinical biomarkers and several brain metrics was observed across cART duration groups. CONCLUSION Our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early and subtle functional changes of brain networks in HIV patients.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,San Raffaele Cassino, Frosinone, Italy
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Nucci C, Garaci F, Altobelli S, Di Ciò F, Martucci A, Aiello F, Lanzafame S, Di Giuliano F, Picchi E, Minosse S, Cesareo M, Guerrisi MG, Floris R, Passamonti L, Toschi N. Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma. J Clin Med 2020; 9:jcm9103122. [PMID: 32992559 PMCID: PMC7600134 DOI: 10.3390/jcm9103122] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells and loss of their axons, progressively leading to blindness. Recently, glaucoma has been conceptualized as a more diffuse neurodegenerative disorder involving the optic nerve and also the entire brain. Consistently, previous studies have used a variety of magnetic resonance imaging (MRI) techniques and described widespread changes in the grey and white matter of patients. Diffusion kurtosis imaging (DKI) provides additional information as compared with diffusion tensor imaging (DTI), and consistently provides higher sensitivity to early microstructural white matter modification. In this study, we employ DKI to evaluate differences among healthy controls and a mixed population of primary open angle glaucoma patients ranging from stage I to V according to Hodapp–Parrish–Anderson visual field impairment classification. To this end, a cohort of patients affected by primary open angle glaucoma (n = 23) and a group of healthy volunteers (n = 15) were prospectively enrolled and underwent an ophthalmological evaluation followed by magnetic resonance imaging (MRI) using a 3T MR scanner. After estimating both DTI indices, whole-brain, voxel-wise statistical comparisons were performed in white matter using Tract-Based Spatial Statistics (TBSS). We found widespread differences in several white matter tracts in patients with glaucoma relative to controls in several metrics (mean kurtosis, kurtosis anisotropy, radial kurtosis, and fractional anisotropy) which involved localization well beyond the visual pathways, and involved cognitive, motor, face recognition, and orientation functions amongst others. Our findings lend further support to a causal brain involvement in glaucoma and offer alternative explanations for a number of multidomain impairments often observed in glaucoma patients.
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Affiliation(s)
- Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
- San Raffaele Cassino, 03043 Frosinone, Italy
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Simone Altobelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Maria Giovanna Guerrisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, 20090 Milano, Italy
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, 149 13th Street, Boston, MA 02129, USA
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Di Ciò F, Garaci F, Minosse S, Passamonti L, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Guerrisi MG, Floris R, Nucci C, Toschi N. Reorganization of the structural connectome in primary open angle Glaucoma. Neuroimage Clin 2020; 28:102419. [PMID: 33032067 PMCID: PMC7552094 DOI: 10.1016/j.nicl.2020.102419] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 12/18/2022]
Abstract
Primary open angle Glaucoma (POAG) is one of the most common causes of permanent blindness in the world. Recent studies have suggested the hypothesis that POAG is also a central nervous system disorder which may result in additional (i.e., extra-ocular) involvement. The aim of this study is to assess possible structural, whole-brain connectivity alterations in POAG patients. We evaluated 23 POAG patients and 15 healthy controls by combining multi-shell diffusion weighted imaging, multi-shell, multi-tissue probabilistic tractography, graph theoretical measures and a recently designed 'disruption index', which evaluates the global reorganization of brain networks. We also studied the associations between the whole-brain structural connectivity measures and indices of visual acuity including the field index (VFI) and two Optical Coherence Tomography (OCT) parameters, namely the Macula Ganglion Cell Layer (MaculaGCL) and Retinal Nerve Fiber Layer (RNFL) thicknesses. We found both global and local structural connectivity differences between POAG patients and controls, which extended well beyond the primary visual pathway and were localized in the left calcarine gyrus (clustering coefficient p = 0.036), left lateral occipital cortex (clustering coefficient p = 0.017, local efficiency p = 0.035), right lingual gyrus (clustering coefficient p = 0.009), and right paracentral lobule (clustering coefficient p = 0.009, local efficiency p = 0.018). Group-wise (clustering coefficient, p = 6.59∙10-7 and local efficiency p = 6.23·10-8) and subject-wise disruption indices (clustering coefficient, p = 0.018 and local efficiency, p = 0.01) also differed between POAG patients and controls. In addition, we found negative associations between RNFL thickness and local measures (clustering coefficient, local efficiency and strength) in the right amygdala (local efficiency p = 0.008, local strength p = 0.016), right inferior temporal gyrus (clustering coefficient p = 0.036, local efficiency p = 0.042), and right temporal pole (local strength p = 0.008). Overall, we show, in patients with POAG, a whole-brain structural reorganization that spans across a variety of brain regions involved in visual processing, motor control, and emotional/cognitive functions. We also identified a pattern of brain structural changes in relation to POAG clinical severity. Taken together, our findings support the hypothesis that the reduction in visual acuity from POAG can be driven by a combination of local (i.e., in the eye) and more extended (i.e., brain) effects.
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Affiliation(s)
- Francesco Di Ciò
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy.
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; San Raffaele Cassino, Frosinone, Italy
| | - Silvia Minosse
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milano, Italy; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Giovanna Guerrisi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy; Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA.
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Cio FD, Garaci F, Minosse S, Passamonti L, Martucci A, Lanzafame S, Giuliano FD, Picchi E, Mancino R, Guerrisi M, Nucci C, Floris R, Toschi N. Disruption of structural brain networks in Primary Open Angle Glaucoma. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1705-1708. [PMID: 33018325 DOI: 10.1109/embc44109.2020.9175417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Primary open angle glaucoma (POAG) is one of the most common causes of permanent blindness in the world. Recent studies have originated the hypothesis that POAG could be considered as a central nervous system pathology which results in secondary visual involvement. The aim of this study is to assess possible structural whole brain connectivity alterations in POAG by combining multi-shell diffusion weighted imaging, multi-shell multi-tissue probabilistic tractography, graph theoretical measures and a newly designed disruption index, which evaluates the global reorganization of brain networks in group-wise comparisons. We found global differences in structural connectivity between Glaucoma patients and controls, as well as in local graph theoretical measures. These changes extended well beyond the primary visual pathway. Furthermore, group-wise and subject-wise disruption indices were found to be statistically different between glaucoma patients and controls, with a positive slope. Overall, our results support the hypothesis of a whole-brain structural reorganization in glaucoma which is specific to structural connectivity, possibly placing this disease within the recently defined groups of brain disconnection syndrome.
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17
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Minosse S, Picchi E, Giuliano FD, Lanzafame S, Manenti G, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Disruption of brain network organization in patients with human immunodeficiency virus (HIV) infection. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1726-1729. [PMID: 33018330 DOI: 10.1109/embc44109.2020.9176449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In 2019, approximately 38 million people were living with human immunodeficiency virus (HIV). Combined antiretroviral therapy (cART) has determined a change in the course of HIV infection, transforming it into a chronic condition which results in cumulative exposure to antiretroviral drugs, inflammatory effects and aging. Relatedly, at least one quarter of HIV-infected patients suffer from cognitive, motor and behavioral disorder, globally known as HIV-associated neurocognitive disorders (HAND). In this context, objective, neuroimaging-based biomarkers are therefore highly desirable in order to detect, quantify and monitor HAND in all disease stages. In this study, we employed functional MRI in conjunction with graph-theoretical analysis as well as a newly developed functional brain network disruption index to assess a putative functional reorganization in HIV positive patients. We found that brain function of HIV patients is deeply reorganized as compared to normal controls. Interestingly, the regions in which we found reorganized hubs are integrated into neuronal networks involved in working memory, motor and executive functions often altered in patients with HAND. Overall, our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early, subtle functional changes of brain networks in HIV patients before structural changes become evident.
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Minosse S, Garaci F, Martino F, Mauro RD, Melis M, Giuliano FD, Picchi E, Floris R, Guerrisi M, Girolamo SD, Toschi N. Global and local reorganization of brain network connectivity in sudden sensorineural hearing loss. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1730-1733. [PMID: 33018331 DOI: 10.1109/embc44109.2020.9175688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recent reports suggested that even moderate sudden sensorineural hearing loss (SSNHL) can be partly responsible for a loss of gray matter volume in the primary auditory cortex, hence reducing the capacity of the auditory cortical areas to react to sound stimulation. There is also evidence for a plastic reorganization of brain functional networks visible as enhanced local functional connectivity. The aim of this study was to use rs-fMRI, in conjunction with graph- theoretical analysis and a newly developed functional "disruption index" to study whole-brain as well as local functional changes in patients with acute and unilateral sensorineural hearing loss. No statistically significant differences in global or local network measures we found between SSNHL patients and healthy controls. However, when analyzing local metrics through the disruption index k, we found negative values for k which were statistically different from zero both in single subject analysis. Additionally, we found several associations between graph-theoretical metrics and clinical parameters.
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Di Giuliano F, Picchi E, Muto M, Calcagni A, Ferrazzoli V, Da Ros V, Minosse S, Chiaravalloti A, Garaci F, Floris R, Muto M. Radiological imaging in multiple myeloma: review of the state-of-the-art. Neuroradiology 2020; 62:905-923. [DOI: 10.1007/s00234-020-02417-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 03/26/2020] [Indexed: 12/16/2022]
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20
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Di Giuliano F, Minosse S, Picchi E, Marfia GA, Da Ros V, Muto M, Muto M, Pistolese CA, Laghi A, Garaci F, Floris R. Comparison between synthetic and conventional magnetic resonance imaging in patients with multiple sclerosis and controls. MAGMA 2019; 33:549-557. [PMID: 31782035 DOI: 10.1007/s10334-019-00804-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 10/30/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Synthetic magnetic resonance imaging (SyMRI) allows to obtain different weighted-images using the multiple-dynamic multiple-echo sequence lasting 6 min. The aim is to compare quantitatively and qualitatively synthetic- and conventional MRI in patients with multiple sclerosis (MS) and controls assessing the contrast (C), the signal to noise ratio (SNR), and the contrast to noise ratio (CNR). We evaluated the lesion count and lesion-to-white matter contrast ([Formula: see text] in the MS patients. METHODS AND METHODS 51 patients underwent synthetic- and conventional MRI. Qualitative analysis was evaluated by assigning scores to all synthetic- and conventional MRI sequences by two neuroradiologists. Lesions were counted in MS patients both in the conventional- and synthetic T2-FLAIR. Regions of interest were placed in the cerebrospinal fluid, in the white- and grey matter. For the sequences were evaluated: C, CNR, and SNR. RESULTS Synthetic T2-FLAIR images are qualitatively inferior. C and CNR were significantly higher in synthetic T1W and T2W images compared to conventional images, but not for T2-FLAIR. The SNR value was always lower in synthetic images than in conventional ones. CONCLUSIONS SyMRI can be used in clinical practice because it has a similar diagnostic accuracy which reduces the scanning time compared to the conventional one. However, synthetic T2-FLAIR images need to be improved.
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Affiliation(s)
- Francesca Di Giuliano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Girolama Alessandra Marfia
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Neurology Unit, Department of Neurosciences, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Valerio Da Ros
- Department of Diagnostic Imaging and Interventional Radiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Massimo Muto
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80100, Naples, Italy
| | - Mario Muto
- Department of Neuroradiology, A.O.R.N. Cardarelli, 80100, Naples, Italy
| | - Chiara Adriana Pistolese
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, Radiology Unit, "Sapienza" University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
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Barranco Pons R, Da Ros V, Scaggiante J, Muniz da Silva G, Picchi E, Di Giuliano F, Aja Rodriguez L, Chirife Chaparro O. Transradial Comaneci-assisted coiling of a direct carotid-cavernous fistula. Radiol Case Rep 2019; 14:1554-1557. [PMID: 31737134 PMCID: PMC6849349 DOI: 10.1016/j.radcr.2019.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 12/02/2022] Open
Abstract
Direct carotid-cavernous fistula is a communication between the internal carotid artery and the cavernous sinus, most of the times established following trauma or rupture of a cavernous aneurysm. The most commonly used treatments (coils, detachable latex balloons, stents, or liquid agents) carry ischemic or hemorrhagic risks, related to hemodynamic diversion of cerebral blood flow or permanent dual antiplatelet therapy. We report a case of coiling of a carotid-cavernous fistula assisted by the Comaneci, a temporary adjustable bridging mesh (Rapid Medical, Israel), to avoid transarterial or -venous migration. In our experience, Comaneci-assisted coiling represents a feasible solution to maintain patency of the distal vessels during coiling and avoid dual antiplatelet medications, even using a transradial approach.
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Affiliation(s)
- Roger Barranco Pons
- Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain
| | - Valerio Da Ros
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy
| | - Jacopo Scaggiante
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy
| | - Greicy Muniz da Silva
- Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain
| | - Eliseo Picchi
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy
| | - Francesca Di Giuliano
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy
| | - Lucia Aja Rodriguez
- Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain
| | - Oscar Chirife Chaparro
- Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain
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22
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Minosse S, Garaci F, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Mancino R, Guerrisi M, Pistolese CA, Floris R, Nucci C, Toschi N. Primary Open Angle Glaucoma Is Associated With Functional Brain Network Reorganization. Front Neurol 2019; 10:1134. [PMID: 31708862 PMCID: PMC6823877 DOI: 10.3389/fneur.2019.01134] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/10/2019] [Indexed: 01/21/2023] Open
Abstract
Background: Resting-state functional magnetic resonance imaging (rs-fMRI) is commonly employed to study changes in functional brain connectivity. The recent hypothesis of a brain involvement in primary open angle Glaucoma has sprung interest for neuroimaging studies in this classically ophthalmological pathology. Object: We explored a putative reorganization of functional brain networks in Glaucomatous patients, and evaluated the potential of functional network disruption indices as biomarkers of disease severity in terms of their relationship to clinical variables as well as select retinal layer thicknesses. Methods: Nineteen Glaucoma patients and 16 healthy control subjects (age: 50–76, mean 61.0 ± 8.2 years) underwent rs-fMRI examination at 3T. After preprocessing, rs-fMRI time series were parcellated into 116 regions using the Automated Anatomical Labeling atlas and adjacency matrices were computed based on partial correlations. Graph-theoretical measures of integration, segregation and centrality as well as group-wise and subject-wise disruption index estimates (which use regression of graph-theoretical metrics across subjects to quantify overall network changes) were then generated for all subjects. All subjects also underwent Optical Coherence Tomography (OCT) and visual field index (VFI) quantification. We then examined associations between brain network measures and VFI, as well as thickness of retinal nerve fiber layer (RNFL) and macular ganglion cell layer (MaculaGCL). Results: In Glaucoma, group-wise disruption indices were negative for all graph theoretical metrics. Also, we found statistically significant group-wise differences in subject-wise disruption indexes in all local metrics. Two brain regions serving as hubs in healthy controls were not present in the Glaucoma group. Instead, three hub regions were present in Glaucoma patients but not in controls. We found significant associations between all disruption indices and VFI, RNFL as well as MaculaGCL. The disruption index based on the clustering coefficient yielded the best discriminative power for differentiating Glaucoma patients from healthy controls [Area Under the ROC curve (AUC) 0.91, sensitivity, 100%; specificity, 78.95%]. Conclusions: Our findings support a possible relationship between functional brain changes and disease severity in Glaucoma, as well as alternative explanations for motor and cognitive symptoms in Glaucoma, possibly pointing toward an inclusion of this pathology in the heterogeneous group of disconnection syndromes.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,San Raffaele Cassino, Cassino, Italy
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Raffaele Mancino
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, United States
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23
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Garaci F, Picchi E, Di Giuliano F, Lanzafame S, Minosse S, Manenti G, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Toschi N. Cerebral Multishell Diffusion Imaging Parameters are Associated with Blood Biomarkers of Disease Severity in HIV Infection. J Neuroimaging 2019; 29:771-778. [PMID: 31304996 DOI: 10.1111/jon.12655] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 04/26/2019] [Revised: 06/23/2019] [Accepted: 06/26/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE HIV-positive subjects suffer from neurocognitive deficits and disorder. We employ multishell diffusion imaging to investigate possible white matter microstructural correlates of infection severity, quantified through plasmatic percentage value of CD4 T-lymphocytes, Nadir-CD4 count, and plasma concentration of human immunodeficiency virus (HIV)-ribonucleic acid (RNA). METHODS A total of 41 HIV patients underwent magnetic resonance imaging (MRI) and blood sampling to evaluate biochemical markers. Diffusion-weighted imaging was performed at 3 Tesla (b-values: 1000 s/mm² and 2500 s/mm², 64 gradient directions/b-value, 8 b0 images). The Diffusion Tensor Imaging and Diffusional Kurtosis Imaging models were fitted separately after which mean, radial, and axial diffusivity (MD, RD, AD, respectively), fractional anistrotropy (FA), mean and radial kurtosis (MK and RK, respectively), and kurtosis anisotropy (KA) maps were extracted. Associations of each metric with biochemical markers were explored through tract-based spatial statistics followed by threshold-free cluster enhancement. RESULTS We found significant positive associations between Nadir-CD4 values and both KA and FA, and significant negative associations between Nadir-CD4 values and MD. Also, we found significant positive associations among %CD4 and MK, KA, and FA, and significant negative associations among %CD4 values and MD. These associations were bilateral and involved predominantly the long association fibers. Anatomically, these associations were more widespread when using KA as compared to FA. No statistically significant associations with HIV-RNA concentrations were found. CONCLUSIONS In HIV-positive subjects, associations between biochemical and diffusion-MRI variables are found along the association fibers, which connect brain areas involved in memory formation, providing a possible interpretation for the neurobiological substrate underlying cognitive disturbances in HIV.
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Affiliation(s)
- Francesco Garaci
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,San Raffaele Cassino, FR, Italy
| | - Eliseo Picchi
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Medical Physics Section, Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Guglielmo Manenti
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Minosse S, Floris R, Nucci C, Toschi N, Garaci F, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Mancino R, Guerrisi M. Disruption of brain network organization in primary open angle glaucoma. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2019:4338-4341. [PMID: 31946828 DOI: 10.1109/embc.2019.8857290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Resting-state functional magnetic resonance imaging (rs-fMRI) is commonly employed to study changes in functional brain connectivity. Recently, the hypothesis of a brain involvement in primary open angle glaucoma has sprung interest for neuroimaging studies in this pathology. The purpose of this study is to evaluate a putative reorganization of brain networks in glaucomatous patients through graph-theoretical measures of integration, segregation and centrality by exploiting a multivariate networks association measure and a recently introduced global and local brain network disruption index. Nineteen glaucoma patients and sixteen healthy control subjects (age: 50 - 76, mean 61 years) underwent rs-fMRI examination at 3T. After preprocessing, rs-fMRI time series were parcellated into 116 regions (AAL atlas), adjacency matrices were computed based on partial correlations and graph-theoretical measures of integration, segregation and centrality as well as group-wise and subject-wise disruption index estimates were generated for all subjects. We found that the group-wise disruption index was negative and statistically different from 0 in for all graph theoretical metrics. Additionally, statistically significant group-wise differences in subject-wise disruption indexes were found in all local metrics. The differences in local network measures highlight cerebral reorganization of brain networks in glaucoma patients, supporting the interpretation of glaucoma as central nervous system disease, likely part of the heterogeneous group of recently described disconnection syndromes.
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25
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Di Giuliano F, Picchi E, Scaggiante J, Ferrante P, Misciasci T, Da Ros V, Pistolese CA, Floris R, Garaci F. Posterior reversible encephalopathy syndrome and Wernicke encephalopathy in patient with acute graft-versus-host disease. Radiol Case Rep 2019; 14:971-976. [PMID: 31193981 PMCID: PMC6545363 DOI: 10.1016/j.radcr.2019.05.024] [Citation(s) in RCA: 1] [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: 02/25/2019] [Revised: 05/19/2019] [Accepted: 05/20/2019] [Indexed: 11/18/2022] Open
Abstract
Graft-versus-host disease (GVHD) is an immune triggered process leading to severe immune dysregulation and organ dysfunction until death and it is one of the worst medical complications after a transplant. Patients with GVHD may have several neurological alterations: during this acute severe phase there is coexistence of various and nonspecific neurological symptoms. We are reporting a case of a 53 year old woman with severe GVHD after bone marrow transplant with acute neurological signs and symptoms. MRI study showed findings consistent with Posterior reversible encephalopathy syndrome and Wernicke encephalopathy.
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Affiliation(s)
- Francesca Di Giuliano
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Jacopo Scaggiante
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Ferrante
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Teresa Misciasci
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Valerio Da Ros
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Policlinico Tor Vergata, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Picchi E, Di Giuliano F, Marziali S, Minosse S, Ferrazzoli V, Da Ros V, Gaziev J, Pistolese CA, Floris R, Garaci F. Radiological findings of Posterior Reversible Encephalopathy Syndrome in transplanted children previous affected by hemoglobinopathy: A neuroimaging retrospective analysis. Eur J Radiol Open 2019; 6:144-151. [PMID: 31016209 PMCID: PMC6468159 DOI: 10.1016/j.ejro.2019.03.001] [Citation(s) in RCA: 3] [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: 01/20/2019] [Accepted: 03/17/2019] [Indexed: 11/15/2022] Open
Abstract
To evaluate, by Magnetic Resonance Imaging, if there is a typical pattern or severity of PRES in transplanted children for hemoglobinopathy. Secondary point was to investigate the pattern and severity of PRES in children with thalassemia-THAL and sickle-cell disease-SCD after autologous hematopoietic stem cell transplantation (aHSCT). Finally, we evaluate the presence of atypical PRES presentation and the involved area of central nervous system. Two neuroradiologists analyzed retrospectively MRI of 21 transplanted children for THAL or SCD treated with CI, with neurological symptoms and signs of PRES. The Bartynski and Boardman classification has been used for PRES pattern while McKinney scale for PRES severity. Fisher Exact Probability test or Chi-square test were used to compare the categorical data. In the 21 transplanted children the PRES severity was typically mild (85.7%) without preferring radiological pattern at MRI. The analysis didn't show significant association between PRES pattern or PRES severity and previous hemoglobinopathy (THAL or SCD). No atypical PRES presentation has been found. PRES severity in transplanted children for hemoglobinopathy is typically mild. Notwithstanding children affected by SCD have a damage on the capillary endothelium, after aHSCT our data didn't show a different PRES severity and pattern than THAL children.
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Affiliation(s)
- Eliseo Picchi
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Simone Marziali
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Valentina Ferrazzoli
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Valerio Da Ros
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Javid Gaziev
- International Center for Transplantation in Thalassemia and Sickle Cell Anemia. Mediterranean Institute ofHematology, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Francesco Garaci
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
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Di Giuliano F, Picchi E, Lacchè A, Bozzi A, Cavaleri Y, Garaci F, Floris R. Congenital kidney malformation: Computed tomography and scintigraphy findings of renal reversed rotation. Radiol Case Rep 2019; 14:678-682. [PMID: 30976367 PMCID: PMC6439229 DOI: 10.1016/j.radcr.2019.03.004] [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: 01/21/2019] [Revised: 02/24/2019] [Accepted: 03/02/2019] [Indexed: 11/18/2022] Open
Abstract
Renal reversed rotation is a congenital abnormality due to anomalous kidney rotation around its long axis, resulting in faced laterally renal hilum; this condition is associated with several vascular variants. The aim of this report is to describe the case of a 47-year-old male with renal reversed rotation who came to our attention after ultrasound exam. The association of renal rotation and vascular anomalies increases long-term complications as kidney lithiasis, hydronephrosis, colic pain, hematuria, and renal failure. We decided to study the anatomy and renal function of the reversed rotated kidney by multiphasic computed tomography and renal dimercaptosuccinic acid-scintigraphy. It is critical for urologists and radiologists to recognize this abnormality in order to plan the best treatment and follow-up.
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Affiliation(s)
- Francesca Di Giuliano
- Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Department of Biomedicine and Prevention, Radiology UOC, Viale Oxford, 81, 00133 Rome, Italy
| | - Eliseo Picchi
- Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Department of Biomedicine and Prevention, Radiology UOC, Viale Oxford, 81, 00133 Rome, Italy
| | - Adriano Lacchè
- Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Department of Biomedicine and Prevention, Radiology UOC, Viale Oxford, 81, 00133 Rome, Italy
| | - Alessio Bozzi
- Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Department of Biomedicine and Prevention, Radiology UOC, Viale Oxford, 81, 00133 Rome, Italy
| | - Yuri Cavaleri
- Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Department of Surgery; Urology UOC, 00133 Rome, Italy
| | - Francesco Garaci
- Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Department of Biomedicine and Prevention, Radiology UOC, Viale Oxford, 81, 00133 Rome, Italy
| | - Roberto Floris
- Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Department of Biomedicine and Prevention, Radiology UOC, Viale Oxford, 81, 00133 Rome, Italy
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Di Giuliano F, Picchi E, Sallustio F, Ferrazzoli V, Alemseged F, Greco L, Minosse S, Da Ros V, Diomedi M, Garaci F, Marziali S, Floris R. Accuracy of advanced CT imaging in prediction of functional outcome after endovascular treatment in patients with large-vessel occlusion. Neuroradiol J 2018; 32:62-70. [PMID: 30303448 DOI: 10.1177/1971400918805710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Computed tomography perfusion (CTP) and multiphase CT angiography (mCTA) help selection for endovascular treatment (EVT) in anterior ischemic stroke (AIS). Our aim was to investigate the ability of perfusion maps and collateral score to predict functional outcome after EVT. PATIENTS AND METHODS Patients with M1-middle cerebral artery occlusion, evaluated by mCTA and CTP and treated with EVT within six hours of onset, were enrolled. Perfusion parametric maps of cerebral blood flow (CBF), cerebral blood volume (CBV) and time to maximum of tissue residue function ( Tmax) were generated; areas of altered perfusion were manually outlined to obtain volumes CBFv, CBVv, Tmax,v16-25s and Tmax,v9.5-25s . Diffusion-weighted imaging (DWI) at 24-36 hours was used to manually outline the ischemic core (volume: DWIv). Collateral vessels were assessed on mCTA considering extent and delay of maximal enhancement (six-point scale). Functional outcome was evaluated by modified Rankin Scale score at three months. Volumes in good and poor outcome groups were compared by Wilcoxon rank-sum test t, and their discriminative ability for outcome was determined by receiver operating characteristic analysis. A logistic regression model, including Tmax, CBF and collaterals, was used to differentiate good and poor outcome. RESULTS Seventy-one patients (mean age 75 ± 11 years, range 45-99 years) were included. Tmax,v16-25s , Tmax,v9.5-25s , CBVv, CBFv and DWIv were statistically different between the two groups. CBF had the best discriminative value for good and poor outcome (area under the curve (AUC) 0.73; 64.5% sensitivity; 74.4% specificity); the logistic regression model might be promising (AUC 0.79, 64.5% sensitivity, 82.1% specificity). CONCLUSIONS In patients with AIS, the combined use of CTP and mCTA predicts functional outcome of EVT and might allow better selection.
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Affiliation(s)
| | - Eliseo Picchi
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Fabrizio Sallustio
- 2 Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Italy
| | | | - Fana Alemseged
- 2 Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Italy.,3 Department of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Australia
| | - Laura Greco
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Silvia Minosse
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Valerio Da Ros
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Marina Diomedi
- 2 Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Italy.,4 I.R.C.C.S., Santa Lucia Foundation, Italy
| | - Francesco Garaci
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Simone Marziali
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Roberto Floris
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
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Picchi E, Di Giuliano F, Ferrari D, Pistolese CA, Garaci F, Floris R. Pleural thymoma: Radiological and histological findings. Eur J Radiol Open 2018; 5:147-152. [PMID: 30191163 PMCID: PMC6125801 DOI: 10.1016/j.ejro.2018.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 08/12/2018] [Accepted: 08/12/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Eliseo Picchi
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Donatella Ferrari
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging and Neuroradiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.,Department of Biomedicine and Prevention, UOC of Diagnostic Imaging, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
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Morosetti D, Picchi E, Calcagni A, Lamacchia F, Cavallo AU, Bozzi A, Lacchè A, Sergiacomi G. Anomalous development of the inferior vena cava: Case reports of agenesis and hypoplasia. Radiol Case Rep 2018; 13:895-903. [PMID: 29997719 PMCID: PMC6037009 DOI: 10.1016/j.radcr.2018.04.018] [Citation(s) in RCA: 8] [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: 01/12/2018] [Revised: 04/09/2018] [Accepted: 04/13/2018] [Indexed: 11/15/2022] Open
Abstract
We reported the cases of two adult male patients who were admitted to our emergency room with abdominal pain and dyspnea caused by gallstones and pulmonary embolism respectively. During the radiological investigations, as collateral findings, we found two anomalous development of the inferior vena cava. These conditions affect about 4% of population and, although asymptomatic or mildly symptomatic, are associated with thrombotic manifestations as deep vein thrombosis and pulmonary embolism. The prompt recognition of these anomalies is necessary in order to prevent the complications associated with these conditions and to set the best therapy for patients.
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Affiliation(s)
- Daniele Morosetti
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Eliseo Picchi
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Antonello Calcagni
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Feliciana Lamacchia
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Armando Ugo Cavallo
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Alessio Bozzi
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Adriano Lacchè
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Gianluigi Sergiacomi
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
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Spallone G, Garofalo V, Picchi E, Pitocco R, Bianchi F, Ventura A, Santoni R, Bianchi L. Prolonged survival of a patient with brain melanoma metastasis treated with BRAF and MEK inhibitors combination therapy. GIORN ITAL DERMAT V 2018; 155:245-247. [PMID: 29747484 DOI: 10.23736/s0392-0488.18.05990-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giulia Spallone
- Department of Dermatology, Tor Vergata University, Rome, Italy -
| | | | - Eliseo Picchi
- Department of Radiology and Medical Imaging, Tor Vergata University, Rome, Italy
| | | | | | | | | | - Luca Bianchi
- Department of Dermatology, Tor Vergata University, Rome, Italy
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32
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Marziali S, Picchi E, Di Giuliano F, Pisani A, Mercuri NB, Floris R, Albanese M. Facial diplegia resembling bilateral Ramsay Hunt Syndrome. J Neurol Sci 2017; 376:109-111. [DOI: 10.1016/j.jns.2017.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 02/20/2017] [Accepted: 03/08/2017] [Indexed: 11/17/2022]
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Marziali S, Picchi E, Di Giuliano F, Altobelli S, Mataluni G, Marfia G, Garaci F, Floris R. Acute disseminated encephalomyelitis following Campylobacter jejuni gastroenteritis: Case report and review of the literature. Neuroradiol J 2017; 30:65-70. [PMID: 27888275 PMCID: PMC5564347 DOI: 10.1177/1971400916680123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We describe a case of a 25-year-old male with a diagnosis of acute disseminated encephalomyelitis (ADEM) following infection with Campylobacter jejuni, which is implicated in various human pathologies regarding the central nervous system (CNS) with acute course like Guillain-Barré syndrome (GBS), Miller-Fisher syndrome (MFS), Bickerstaff's brainstem encephalitis (BEE), acute transverse myelitis (ATM) as well as ADEM. These conditions are caused by cross-reactivity between Campylobacter's epitopes and cells of the CNS that causes an immunomediated inflammatory demyelination of the CNS. In the acute phase, magnetic resonance (MR) can detect pathologic signal intensity at the CNS with areas of pathologic contrast enhancement at cortical and spinal white matter that normalize over time or can be stable. These findings can be associated with edema in parts of the CNS. The lesions typically appear at different times during the disease course and also can have a different evolution. Our purpose therefore was to describe the clinical course and MR findings of this case and perform a critical review of the literature.
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Affiliation(s)
- Simone Marziali
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Eliseo Picchi
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Francesca Di Giuliano
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Simone Altobelli
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Giorgia Mataluni
- Neurology COU, Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Girolama Marfia
- Neurology COU, Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Francesco Garaci
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Roberto Floris
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
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34
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Manenti G, Picchi E, Castrignanò A, Muto M, Nezzo M, Floris R. Liver lipoma: a case report. BJR Case Rep 2016; 3:20150467. [PMID: 30363260 PMCID: PMC6159265 DOI: 10.1259/bjrcr.20150467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/23/2015] [Revised: 09/20/2016] [Accepted: 10/11/2016] [Indexed: 12/03/2022] Open
Abstract
Liver lipoma is a rare benign mesenchymal tumour without malignant degeneration. Lesions may be asymptomatic, nevertheless they may sometimes cause abdominal pain depending upon the size. Usually liver lipomas are an incidental finding during radiological examinations performed for other reasons, and there is no evidence of familiar genetic cluster or predisposing factors but it seems to have a strong association with impaired lipidic profile. In this report, we describe the case of a 72 year old female with a giant liver lipoma observed during an ultrasound examination. The clinical examination was completed with CT and MRI scans. Features of the lesion such as negative attenuation values on multiphasic CT examination and MRI signal drop-out on T2 spectral presaturation with inversion recovery sequences, with no enhancement after administration of contrast medium, are suggestive for this kind of benign neoplasm. The purpose of this report is provide an anthological case of liver lipoma, helping to define the diagnostic features with imaging techniques.
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Affiliation(s)
- Guglielmo Manenti
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione PTV Policlinico Tor Vergata, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione PTV Policlinico Tor Vergata, University of Rome "Tor Vergata", Rome, Italy
| | - Antonella Castrignanò
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione PTV Policlinico Tor Vergata, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Muto
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione PTV Policlinico Tor Vergata, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Nezzo
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione PTV Policlinico Tor Vergata, University of Rome "Tor Vergata", Rome, Italy
| | - Roberto Floris
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Fondazione PTV Policlinico Tor Vergata, University of Rome "Tor Vergata", Rome, Italy
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Marziali S, Di Giuliano F, Picchi E, Natoli S, Leonardis C, Leonardis F, Garaci F, Floris R. Non-convulsive status epilepticus in a patient with carbon-monoxide poisoning treated with hyperbaric oxygen therapy. Neuroradiol J 2016; 29:431-435. [PMID: 27549147 DOI: 10.1177/1971400916665379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The presentation of carbon monoxide poisoning is non-specific and highly variable. Hyperbaric oxygen therapy is used for the treatment of this condition. Various reports show the occurrence of self-limiting seizures after carbon monoxide poisoning and as a consequence of hyperbaric oxygen therapy. Contrary to the seizures, status epilepticus has been rarely observed in these conditions. The exact pathophysiology underlying seizures and status epilepticus associated with carbon monoxide poisoning and hyperbaric oxygen therapy is not really clear, and some elements appear to be common to both conditions. We describe a case of non-convulsive status epilepticus in a patient with carbon monoxide poisoning treated with hyperbaric oxygen therapy. The mechanism, MRI findings and implications are discussed.
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Affiliation(s)
- Simone Marziali
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Francesca Di Giuliano
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Eliseo Picchi
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Silvia Natoli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Carlo Leonardis
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Francesca Leonardis
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Francesco Garaci
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Roberto Floris
- Neuroradiology COU, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
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Maillard M, Picchi E. [Current aspects of the after care of schizophrenic patients]. Ann Med Psychol (Paris) 1985; 143:946-51. [PMID: 2873775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Daskalopoulos NT, Cottereau MJ, Picchi E. [Approach to resistance to treatment by neuroleptic combinations]. Ann Med Psychol (Paris) 1977; 2:333-51. [PMID: 596765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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