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Dalmonte S, Golinelli P, Oberhofer N, Strocchi S, Rossetti V, Berta L, Porzio M, Angelini L, Paruccini N, Villa R, Bertolini M, Delle Canne S, Cavallari M, D'Ercole L, Guerra G, Rosasco R, Cannillo B, D'Alessio A, Di Nicola E, Origgi D, De Marco P, Maldera A, Scabbio C, Rottoli F, Castriconi R, Lorenzini E, Pasquali G, Pietrobon F, Bregant P, Giovannini G, Favuzza V, Bruschi A, D'Urso D, Maestri D, De Novellis S, Fracassi A, Boschiroli L, Quattrocchi M, Gilio MA, Roberto E, Altabella L, Califano G, Cimmino MC, Bortoli E, Deiana E, Pagan L, Berardi P, Ardu V, Azzeroni R, Campoleoni M, Ravaglia V. Typical values of z-resolution for different Digital Breast Tomosynthesis systems evaluated in a multicenter study. Phys Med 2024; 119:103300. [PMID: 38325222 DOI: 10.1016/j.ejmp.2024.103300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/07/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE The aim of the present study, conducted by a working group of the Italian Association of Medical Physics (AIFM), was to define typical z-resolution values for different digital breast tomosynthesis (DBT) models to be used as a reference for quality control (QC). Currently, there are no typical values published in internationally agreed QC protocols. METHODS To characterize the z-resolution of the DBT models, the full width at half maximum (FWHM) of the artifact spread function (ASF), a technical parameter that quantifies the signal intensity of a detail along reconstructed planes, was analyzed. Five different commercial phantoms, CIRS Model 011, CIRS Model 015, Modular DBT phantom, Pixmam 3-D, and Tomophan, were evaluated on reconstructed DBT images and 82 DBT systems (6 vendors, 9 models) in use at 39 centers in Italy were involved. RESULTS The ASF was found to be dependent on the detail size, the DBT angular acquisition range, the reconstruction algorithm and applied image processing. In particular, a progressively greater signal spread was observed as the detail size increased and the acquisition angle decreased. However, a clear correlation between signal spread and angular range width was not observed due to the different signal reconstruction and image processing strategies implemented in the algorithms developed by the vendors studied. CONCLUSIONS The analysis led to the identification of typical z-resolution values for different DBT model-phantom configurations that could be used as a reference during a QC program.
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Affiliation(s)
- S Dalmonte
- Medical Physics Specialization School, University of Bologna, Bologna, Italy; Medical Physics Unit, AUSL Romagna, Ravenna, Italy.
| | - P Golinelli
- Medical Physics Unit, Azienda USL Modena, Modena, Italy
| | | | - S Strocchi
- Medical Physics Unit, ASST dei Sette Laghi, Varese, Italy
| | - V Rossetti
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - L Berta
- Medical Physics Unit, Città della salute e della scienza, Torino, Italy
| | - M Porzio
- Medical Physics Unit, ASL CN1, Cuneo, Italy
| | - L Angelini
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
| | - N Paruccini
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - R Villa
- Medical Physics Unit, ASST Monza, Monza, Italy
| | - M Bertolini
- Medical Physics Unit, Azienda AUSL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - S Delle Canne
- Medical Physics Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola, Roma, Italy
| | - M Cavallari
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - L D'Ercole
- Medical Physics Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - G Guerra
- Medical Physics Unit, Studio Associato Fisici Sanitari, Lugo, Italy
| | - R Rosasco
- Medical Physics Unit, ASL3 Sistema Sanitario Regione Liguria, Genova, Italy
| | - B Cannillo
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - A D'Alessio
- Medical Physics Unit, AOU Maggiore della Carità, Novara, Italy
| | - E Di Nicola
- Medical Physics Unit, ASUR Marche Area Vasta3, Macerata, Italy
| | - D Origgi
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - P De Marco
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - A Maldera
- Medical Physics Unit, P.O. Dimiccoli - ASL BT, Barletta, Italy
| | - C Scabbio
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - F Rottoli
- Medical Physics Unit, ASST Santi Paolo e Carlo - Presidio San Paolo, Milano, Italy
| | - R Castriconi
- Medical Physics Unit, IRCCS Ospedale San Raffaele - Gruppo San Donato, Milano, Italy
| | - E Lorenzini
- Medical Physics Unit, Ospedale Civico di Carrara, Carrara, Italy
| | - G Pasquali
- Medical Physics Unit, ASST Bergamo Ovest, Treviglio, Italy
| | - F Pietrobon
- Medical Physics Unit, Ospedale di Belluno, Belluno, Italy
| | - P Bregant
- Medical Physics Unit, Ospedale Cattinara, Trieste, Italy
| | - G Giovannini
- Medical Physics Unit, ASL2 Ospedale Santa Corona, Pietra Ligure, Italy
| | - V Favuzza
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - A Bruschi
- Medical Physics Unit, USL Toscana Centro, Empoli, Italy
| | - D D'Urso
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | - D Maestri
- Medical Physics Unit, ULSS 2 Marca Trevigiana, Treviso, Italy
| | | | - A Fracassi
- Medical Physics Unit, ASL Pescara, Pescara, Italy
| | - L Boschiroli
- Medical Physics Unit, ASST Nord Milano, Milano, Italy
| | - M Quattrocchi
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - M A Gilio
- Medical Physics Unit, Azienda Toscana Nord Ovest, Lucca, Italy
| | - E Roberto
- Medical Physics Unit, ASL CN2 Cuneo, Italy
| | - L Altabella
- Medical Physics Unit, AOUI VR, Verona, Italy
| | - G Califano
- Medical Physics Unit, AOR San Carlo Potenza, Potenza, Italy
| | - M C Cimmino
- Medical Physics Unit, USL Toscana sud est, Siena, Italy
| | - E Bortoli
- Medical Physics Unit, USL Toscana sud est, Grosseto, Italy
| | - E Deiana
- Medical Physics Unit, ASL Cagliari, Cagliari, Italy
| | - L Pagan
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - P Berardi
- Medical Physics Unit, Azienda USL Bologna, Bologna, Italy
| | - V Ardu
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - R Azzeroni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - M Campoleoni
- Medical Physics Unit, Fondazione IRCCS Ca' Granda, Milano, Italy
| | - V Ravaglia
- Medical Physics Unit, AUSL Romagna, Ravenna, Italy
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Ghetti C, Ortenzia O, Maddalo M, Altabella L, Sverzellati N. Dosimetric and radiation cancer risk evaluation of high resolution thorax CT during COVID-19 outbreak. Phys Med 2021. [PMCID: PMC8767682 DOI: 10.1016/s1120-1797(22)00062-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Fedeli L, Belli G, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Bernardi L, Betti M, Caivano R, Carni M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliado G, Morzenti S, Niespolo A, Nocetti L, Noferini L, Oberhofer N, Orsingher L, Quattrocchi M, Ricci A, Savini A, Taddeucci A, Testa C, Tortoli P, Luchinat C, Tenori L, Gobbi G, Gori C, Busoni S, Mazzoni L. Multicenter comparison of MR scanners for quantitative diffusion weighted imaging: apparent diffusion coefficient dependence on acquisition plan and spatial position – preliminary results. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00475-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ghetti C, Ortenzia O, Maddalo M, Altabella L, Sverzellati N. Dosimetric and radiation cancer risk evaluation of high resolution thorax CT during COVID-19 outbreak. Phys Med 2020; 80:119-124. [PMID: 33171381 PMCID: PMC7604119 DOI: 10.1016/j.ejmp.2020.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/12/2020] [Accepted: 10/22/2020] [Indexed: 01/19/2023] Open
Abstract
PURPOSE The aim of this work was to evaluate the dosimetric impact of high-resolution thorax CT during COVID-19 outbreak in the University Hospital of Parma. In two months we have performed a huge number of thorax CT scans collecting effective and equivalent organ doses and evaluating also the lifetime attributable risk (LAR) of lung and other major cancers. MATERIALS AND METHOD From February 24th to April 28th, 3224 high-resolution thorax CT were acquired. For all patients we have examined the volumetric computed tomography dose index (CTDIvol), the dose length product (DLP), the size-specific dose estimate (SSDE) and effective dose (E103) using a dose tracking software (Radimetrics Bayer HealthCare). From the equivalent dose to organs for each patient, LAR for lung and major cancers were estimated following the method proposed in BEIR VII which considers age and sex differences. RESULTS Study population included 3224 patients, 1843 male and 1381 female, with an average age of 67 years. The average CTDIvol, SSDE and DLP, and E103 were 6.8 mGy, 8.7 mGy, 239 mGy·cm and 4.4 mSv respectively. The average LAR of all solid cancers was 2.1 cases per 10,000 patients, while the average LAR of leukemia was 0.2 cases per 10,000 patients. For both male and female the organ with a major cancer risk was lung. CONCLUSIONS Despite the impressive increment in thoracic CT examinations due to COVID-19 outbreak, the high resolution low dose protocol used in our hospital guaranteed low doses and very low risk estimation in terms of LAR.
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Affiliation(s)
- C Ghetti
- Department of Medical Physics, University Hospital of Parma, Italy
| | - O Ortenzia
- Department of Medical Physics, University Hospital of Parma, Italy.
| | - M Maddalo
- Department of Medical Physics, University Hospital of Parma, Italy
| | - L Altabella
- Department of Medical Physics, University Hospital of Parma, Italy
| | - N Sverzellati
- Department of Medicine and Surgery, Division of Radiology, University of Parma, Italy
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Maddalo M, Altabella L, Pegurri L, Guerini A, Peretto G, Alghisi A, Turla O, Guaineri A, Costantino G, Spiazzi L, Costa L, Mozzetti C, Pasinetti N, Buglione M. PO-1572: Use of intravoxel incoherent motion (IVIM) MRI for predicting dysphagia in oropharyngeal carcinoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01590-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Conte GM, Altabella L, Castellano A, Cuccarini V, Bizzi A, Grimaldi M, Costa A, Caulo M, Falini A, Anzalone N. Comparison of T1 mapping and fixed T1 method for dynamic contrast-enhanced MRI perfusion in brain gliomas. Eur Radiol 2019; 29:3467-3479. [PMID: 30972545 DOI: 10.1007/s00330-019-06122-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/14/2019] [Accepted: 02/22/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To compare dynamic contrast-enhanced MRI (DCE-MRI) data obtained using different prebolus T1 values in glioma grading and molecular profiling. METHODS We retrospectively reviewed 83 cases of gliomas: 46 lower-grade gliomas (LGG; grades II and III) and 37 high-grade gliomas (HGG; grade IV). DCE-MRI maps of plasma volume fraction (Vp), extravascular-extracellular volume fraction (Ve), and tracer transfer constant from plasma to tissue (Ktrans) were obtained using a fixed T1 value of 1400 ms and a measured T1 obtained with variable flip angle (VFA). Tumour segmentations were performed and first-order histogram parameters were extracted from volumes of interest (VOIs) after co-registration with the perfusion maps. The two methods were compared using Wilcoxon matched-pairs signed-rank test and Bland-Altman analysis. Diagnostic accuracy was obtained and compared using ROC curve analysis and DeLong's test. RESULTS Perfusion parameters obtained with the fixed T1 value were significantly higher than those obtained with the VFA. As regards diagnostic accuracy, there were no significant differences between the two methods both for glioma grading and molecular classification, except for few parameters of both methods. CONCLUSIONS DCE-MRI data obtained with different prebolus T1 are not comparable and the definition of a prebolus T1 by T1 mapping is not mandatory since it does not improve the diagnostic accuracy of DCE-MRI. KEY POINTS • DCE-MRI data obtained with different prebolus T1 are significantly different, thus not comparable. • The definition of a prebolus T1 by T1 mapping is not mandatory since it does not improve the diagnostic accuracy of DCE-MRI for glioma grading. • The use of a fixed T1 value represents a valid alternative to T1 mapping for DCE-MRI analysis.
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Affiliation(s)
- G M Conte
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - L Altabella
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - A Castellano
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - V Cuccarini
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Bizzi
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M Grimaldi
- Department of Radiology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - A Costa
- Department of Neuroradiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Caulo
- Department of Neuroscience and Imaging and ITAB-Institute of Advanced Biomedical Technologies, University G. D'Annunzio, Chieti, Italy
| | - A Falini
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - N Anzalone
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
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Coniglio A, Fedeli L, Belli G, Ciccarone A, Esposito M, Giannelli M, Gobbi G, Gori C, Mazzoni L, Nocetti L, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Betti M, Caivano R, Carnì M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Luchinat C, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Noferini L, Oberhofer N, Quattrocchi M, Ricci A, Taddeucci A, Tenori L, Torresin A, Busoni S. 20. Diffusion MRI and ADC accuracy at the isocenter: An AIFM multisite comparison study. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Fedeli L, Belli G, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Gobbi G, Gori C, Mazzoni L, Nocetti L, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Betti M, Caivano R, Carnì M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Luchinat C, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Noferini L, Oberhofer N, Quattrocchi M, Ricci A, Taddeucci A, Tenori L, Torresin A, Busoni S. 21 Phase encoding direction and position effects on ADC in diffusion MRI: An AFIM multisite comparison study. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Spiazzi L, Toraci C, Frassine F, Borghetti P, Altabella L, Vitali P, Polonini A, Moretti R. 45 Threshold dose for focal liver reaction. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Moretti R, Toraci C, Polonini A, Altabella L, Saiani F, Pegurri L, Buglione M, Spiazzi L. 183. Retrospective analysis of Tomotherapy dose-of-the-day: Results and effectiveness on adaptive strategies. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Politi LS, Brugnara G, Castellano A, Cadioli M, Altabella L, Peviani M, Mazzoleni S, Falini A, Galli R. T1-Weighted Dynamic Contrast-Enhanced MRI Is a Noninvasive Marker of Epidermal Growth Factor Receptor vIII Status in Cancer Stem Cell-Derived Experimental Glioblastomas. AJNR Am J Neuroradiol 2016; 37:E49-51. [PMID: 26988813 DOI: 10.3174/ajnr.a4774] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- L S Politi
- Neuroimaging Research, Hematology/Oncology Division Boston Children's Hospital/Dana Farber Cancer Institute Boston, Massachusetts Radiology Department University of Massachusetts Medical School Worcester, Massachusetts Neuroradiology Unit and CERMAC Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute Milan, Italy
| | - G Brugnara
- Neuroradiology Unit and CERMAC Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute Milan, Italy
| | - A Castellano
- Neuroradiology Unit and CERMAC Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute Milan, Italy
| | - M Cadioli
- Neuroradiology Unit and CERMAC Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute Milan, Italy
| | - L Altabella
- Neuroradiology Unit and CERMAC Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute Milan, Italy
| | - M Peviani
- Neuroimaging Research, Hematology/Oncology Division Boston Children's Hospital/Dana Farber Cancer Institute Boston, Massachusetts Neuroradiology Unit and CERMAC Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute Milan, Italy
| | - S Mazzoleni
- Neural Stem Cell Biology Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy IRCCS San Raffaele Scientific Institute Milan, Italy
| | - A Falini
- Neuroradiology Unit and CERMAC Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute Milan, Italy
| | - R Galli
- Neural Stem Cell Biology Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy IRCCS San Raffaele Scientific Institute, Milan, Italy
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Altabella L, Zoratto F, Adriani W, Canese R. MR imaging-detectable metabolic alterations in attention deficit/hyperactivity disorder: from preclinical to clinical studies. AJNR Am J Neuroradiol 2014; 35:S55-63. [PMID: 24481327 DOI: 10.3174/ajnr.a3843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
MR spectroscopy represents one of the most suitable in vivo tool to assess neurochemical dysfunction in several brain disorders, including attention deficit/hyperactivity disorder. This is the most common neuropsychiatric disorder in childhood and adolescence, which persists into adulthood (in approximately 30%-50% of cases). In past years, many studies have applied different MR spectroscopy techniques to investigate the pathogenesis and effect of conventional treatments. In this article, we review the most recent clinical and preclinical MR spectroscopy results on subjects with attention deficit/hyperactivity disorder and animal models, from childhood to adulthood. We found that the most investigated brain regions were the (pre)frontal lobes and striatum, both involved in the frontostriatal circuits and networks that are known to be impaired in this pathology. Neurometabolite alterations were detected in several regions: the NAA, choline, and glutamatergic compounds. The creatine pool was also altered when an absolute quantitative protocol was adopted. In particular, glutamate was increased in children with attention deficit/hyperactivity disorder, and this can apparently be reversed by methylphenidate treatment. The main difficulties in reviewing MR spectroscopy studies were in the nonhomogeneity of the analyzed subjects, the variety of the investigated brain regions, and also the use of different MR spectroscopy techniques. As for possible improvements in future studies, we recommend the use of standardized protocols and the analysis of other brain regions of particular interest for attention deficit hyperactivity disorder, like the hippocampus, limbic structures, thalamus, and cerebellum.
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Affiliation(s)
- L Altabella
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy
| | - F Zoratto
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, ItalyBambino Gesù Children's Hospital IRCCS (F.Z.), Rome, Italy
| | - W Adriani
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy
| | - R Canese
- From the Department of Cell Biology and Neurosciences (L.A., F.Z., W.A., R.C.), Istituto Superiore di Sanità, Rome, Italy
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