1
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Bauckneht M, Fornarini G, Di Raimondo T, Pardini M, Donegani MI, Banna GL, Di Maio M, Morbelli S. Brain Metabolic Correlates of the Off-Target Effects of Enzalutamide on the Central Nervous System of Patients with Advanced Prostate Cancer. J Nucl Med 2024:jnumed.124.267526. [PMID: 38604757 DOI: 10.2967/jnumed.124.267526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/15/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
| | | | | | | | | | - Giuseppe Luigi Banna
- Portsmouth Hospitals University NHS Trust, University of Portsmouth, Portsmouth, United Kingdom; and
| | - Massimo Di Maio
- AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Silvia Morbelli
- AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
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2
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Marini C, Cossu V, Lanfranchi F, Carta S, Vitale F, D'Amico F, Bauckneht M, Morbelli S, Donegani MI, Chiola S, Raffa S, Sofia L, Di Raimondo T, Ballerini F, Ghiggi C, Durando P, Ravera S, Riondato M, Orengo AM, Bruno S, Chiesa S, Sambuceti G. Divergent Oxidative Stress in Normal Tissues and Inflammatory Cells in Hodgkin and Non-Hodgkin Lymphoma. Cancers (Basel) 2023; 15:3533. [PMID: 37444643 DOI: 10.3390/cancers15133533] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Previous studies reported mitochondrial and endoplasmic reticulum redox stress in peripheral blood mononucleated cells (PBMCs) of treatment-naïve Hodgkin lymphoma (HL) patients. Here, we assessed whether this response also applies to non-HL (NHL) patients, and whether the oxidative damage is a selective feature of PBMCs or, rather, also affects tissues not directly involved in the inflammatory response. METHODS Isolated PBMCs of 28 HL, 9 diffuse large B cell lymphoma, 8 less aggressive-NHL, and 45 controls underwent flow cytometry to evaluate redox stress and uptake of the glucose analogue 2-NBDG. This analysis was complemented with the assay of malondialdehyde (MDA) levels and enzymatic activity of glucose-6P-dehydrogenase and hexose-6P-dehydrogenase (H6PD). In all lymphoma patients, 18F-fluoro-deoxyglucose uptake was estimated in the myocardium and skeletal muscles. RESULTS Mitochondrial reactive oxygen species generation and MDA levels were increased only in HL patients as well as H6PD activity and 2-NBDG uptake. Similarly, myocardial FDG retention was higher in HL than in other groups as opposed to a similar tracer uptake in the skeletal muscle. CONCLUSIONS Redox stress of PBMCs is more pronounced in HL with respect to both NHL groups. This phenomenon is coherent with an increased activity of H6PD that also extends to the myocardium.
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Affiliation(s)
- Cecilia Marini
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), 20054 Milan, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Vanessa Cossu
- Human Anatomy Section, Department of Experimental Medicine, University of Genoa, 16132 Genova, Italy
| | | | - Sonia Carta
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | | | - Francesca D'Amico
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy
| | | | - Silvia Chiola
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Stefano Raffa
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Luca Sofia
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy
| | - Tania Di Raimondo
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy
| | - Filippo Ballerini
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy
| | - Chiara Ghiggi
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy
| | - Silvia Ravera
- Human Anatomy Section, Department of Experimental Medicine, University of Genoa, 16132 Genova, Italy
| | | | | | - Silvia Bruno
- Human Anatomy Section, Department of Experimental Medicine, University of Genoa, 16132 Genova, Italy
| | - Sabrina Chiesa
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Gianmario Sambuceti
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy
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3
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Nieri A, Manco L, Bauckneht M, Urso L, Caracciolo M, Donegani MI, Borgia F, Vega K, Colella A, Ippolito C, Cittanti C, Morbelli S, Sambuceti G, Turra A, Panareo S, Bartolomei M. [18F]FDG PET-TC radiomics and machine learning in the evaluation of prostate incidental uptake. Expert Rev Med Devices 2023; 20:1183-1191. [PMID: 37942630 DOI: 10.1080/17434440.2023.2280685] [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: 07/11/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
AIM To evaluate the relevance of incidental prostate [18F]FDG uptake (IPU) and to explore the potential of radiomics and machine learning (ML) to predict prostate cancer (PCa). METHODS We retrieved [18F]FDG PET/CT scans with evidence of IPU performed in two institutions between 2015 and 2021. Patients were divided into PCa and non-PCa, according to the biopsy. Clinical and PET/CT-derived information (comprehensive of radiomic analysis) were acquired. Five ML models were developed and their performance in discriminating PCa vs non-PCa IPU was evaluated. Radiomic analysis was investigated to predict ISUP Grade. RESULTS Overall, 56 IPU were identified and 31 patients performed prostate biopsy. Eighteen of those were diagnosed as PCa. Only PSA and radiomic features (eight from CT and nine from PET images, respectively) showed statistically significant difference between PCa and non-PCa patients. Eight features were found to be robust between the two institutions. CT-based ML models showed good performance, especially in terms of negative predictive value (NPV 0.733-0.867). PET-derived ML models results were less accurate except the Random Forest model (NPV = 0.933). Radiomics could not accurately predict ISUP grade. CONCLUSIONS Paired with PSA, radiomic analysis seems to be promising to discriminate PCa/non-PCa IPU. ML could be a useful tool to identify non-PCa IPU, avoiding further investigations.
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Affiliation(s)
- Alberto Nieri
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
| | - Luigi Manco
- Medical Physics Unit, Azienda USL of Ferrara, Ferrara, Italy
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Luca Urso
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Nuclear Medicine, PET/CT Centre, S. Maria della Misericordia Hospital, Rovigo, Italy
| | - Matteo Caracciolo
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
| | | | - Francesca Borgia
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Kevin Vega
- Centro Nacional de Radioterapia, Physics Unit, San Salvador, El Salvador
| | - Alessandro Colella
- Urology Unit, Surgical Department, University Hospital of Ferrara, Ferrara, Italy
| | - Carmelo Ippolito
- Urology Unit, Surgical Department, University Hospital of Ferrara, Ferrara, Italy
| | - Corrado Cittanti
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Alessandro Turra
- Medical Physics Unit, University Hospital of Ferrara, Cona, Italy
| | - Stefano Panareo
- Nuclear Medicine Unit, Oncology and Haematology Department, University Hospital of Modena, Modena, Italy
| | - Mirco Bartolomei
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
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4
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Borea R, Favero D, Miceli A, Donegani MI, Raffa S, Gandini A, Cremante M, Marini C, Sambuceti G, Zanardi E, Morbelli S, Fornarini G, Rebuzzi SE, Bauckneht M. Beyond the Prognostic Value of 2-[18F]FDG PET/CT in Prostate Cancer: A Case Series and Literature Review Focusing on the Diagnostic Value and Impact on Patient Management. Diagnostics (Basel) 2022; 12:diagnostics12030581. [PMID: 35328134 PMCID: PMC8947589 DOI: 10.3390/diagnostics12030581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/01/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 12/04/2022] Open
Abstract
The role of 2-deoxy-2-[18F]fluoro-D-glucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in the management of prostate cancer (PCa) patients is increasingly recognised. However, its clinical role is still controversial. Many published studies showed that FDG PET/CT might have a prognostic value in the metastatic castration-resistant phase of the disease, but its role in other settings of PCa and, more importantly, its impact on final clinical management remains to be further investigated. We describe a series of six representative clinical cases of PCa in different clinical settings, but all characterised by a measurable clinical impact of FDG PET/CT on the patients’ management. Starting from their clinical history, we report a concise narrative literature review on the advantages and limitations of FDG PET/CT beyond its prognostic value in PCa. What emerges is that in selected cases, this imaging technique may represent a useful tool in managing PCa patients. However, in the absence of dedicated studies to define the optimal clinical setting of its application, no standard recommendations on its use in PCa patients can be made.
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Affiliation(s)
- Roberto Borea
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Diletta Favero
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
- Medical Oncology Unit 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Annalice Gandini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Malvina Cremante
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20054 Segrate, Italy
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Sara Elena Rebuzzi
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, 16132 Genova, Italy
- Medical Oncology Unit, Ospedale San Paolo, 17100 Savona, Italy
| | - Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
- Correspondence:
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5
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Bauckneht M, Lai R, D'Amico F, Miceli A, Donegani MI, Campi C, Schenone D, Raffa S, Chiola S, Lanfranchi F, Rebuzzi SE, Zanardi E, Cremante M, Marini C, Fornarini G, Morbelli S, Piana M, Sambuceti G. Opportunistic skeletal muscle metrics as prognostic tools in metastatic castration-resistant prostate cancer patients candidates to receive Radium-223. Ann Nucl Med 2022; 36:373-383. [PMID: 35044592 PMCID: PMC8938339 DOI: 10.1007/s12149-022-01716-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 12/11/2022]
Abstract
Objective Androgen deprivation therapy alters body composition promoting a significant loss in skeletal muscle (SM) mass through inflammation and oxidative damage. We verified whether SM anthropometric composition and metabolism are associated with unfavourable overall survival (OS) in a retrospective cohort of metastatic castration-resistant prostate cancer (mCRPC) patients submitted to 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) imaging before receiving Radium-223. Patients and methods Low-dose CT were opportunistically analysed using a cross-sectional approach to calculate SM and adipose tissue areas at the third lumbar vertebra level. Moreover, a 3D computational method was used to extract psoas muscles to evaluate their volume, Hounsfield Units (HU) and FDG retention estimated by the standardized uptake value (SUV). Baseline established clinical, lab and imaging prognosticators were also recorded. Results SM area predicted OS at univariate analysis. However, this capability was not additive to the power of mean HU and maximum SUV of psoas muscles volume. These factors were thus combined in the Attenuation Metabolic Index (AMI) whose power was tested in a novel uni- and multivariable model. While Prostate-Specific Antigen (PSA), Alkaline Phosphatase (ALP), Lactate Dehydrogenase and Hemoglobin, Metabolic Tumor Volume, Total Lesion Glycolysis and AMI were associated with long-term OS at the univariate analyses, only PSA, ALP and AMI resulted in independent prognosticator at the multivariate analysis. Conclusion The present data suggest that assessing individual 'patients' SM metrics through an opportunistic operator-independent computational analysis of FDG PET/CT imaging provides prognostic insights in mCRPC patients candidates to receive Radium-223. Graphical abstract ![]()
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Affiliation(s)
- Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy. .,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Rita Lai
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Francesca D'Amico
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | | | - Cristina Campi
- LISCOMP, Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Daniela Schenone
- LISCOMP, Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Silvia Chiola
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Sara Elena Rebuzzi
- Medical Oncology, Ospedale San Paolo, Savona, Italy.,Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genoa, Italy
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Malvina Cremante
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Bioimaging and Physiology (IBFM), CNR Institute of Molecular, Segrate, Milan, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Michele Piana
- LISCOMP, Department of Mathematics (DIMA), University of Genoa, Genoa, Italy.,CNR-SPIN Genoa, Genoa, Italy
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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6
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Morbelli S, Chiola S, Donegani MI, Arnaldi D, Pardini M, Mancini R, Lanfranchi F, D'amico F, Bauckneht M, Miceli A, Biassoni E, Orso B, Barisione E, Benedetti L, Gianmario S, Nobili F. Metabolic correlates of olfactory dysfunction in COVID-19 and Parkinson's disease (PD) do not overlap. Eur J Nucl Med Mol Imaging 2022; 49:1939-1950. [PMID: 34984501 PMCID: PMC8727173 DOI: 10.1007/s00259-021-05666-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/19/2021] [Indexed: 12/20/2022]
Abstract
Purpose Hyposmia is a common feature of COVID-19 and Parkinson’s disease (PD). As parkinsonism has been reported after COVID-19, a link has been hypothesized between SARS-CoV2 infection and PD. We aimed to evaluate brain metabolic correlates of isolated persistent hyposmia after mild-to-moderate COVID-19 and to compare them with metabolic signature of hyposmia in drug-naïve PD patients. Methods Forty-four patients who experienced hyposmia after SARS-COV2 infection underwent brain [18F]-FDG PET in the first 6 months after recovery. Olfaction was assessed by means of the 16-item “Sniffin’ Sticks” test and patients were classified as with or without persistent hyposmia (COVID-hyposmia and COVID-no-hyposmia respectively). Brain [18F]-FDG PET of post-COVID subgroups were compared in SPM12. COVID-hyposmia patients were also compared with eighty-two drug-naïve PD patients with hyposmia. Multiple regression analysis was used to identify correlations between olfactory test scores and brain metabolism in patients’ subgroups. Results COVID-hyposmia patients (n = 21) exhibited significant hypometabolism in the bilateral gyrus rectus and orbitofrontal cortex with respect to COVID-non-hyposmia (n = 23) (p < 0.002) and in middle and superior temporal gyri, medial/middle frontal gyri, and right insula with respect to PD-hyposmia (p < 0.012). With respect to COVID-hyposmia, PD-hyposmia patients showed hypometabolism in inferior/middle occipital gyri and cuneus bilaterally. Olfactory test scores were directly correlated with metabolism in bilateral rectus and medial frontal gyri and in the right middle temporal and anterior cingulate gyri in COVID-hyposmia patients (p < 0.006) and with bilateral cuneus/precuneus and left lateral occipital cortex in PD-hyposmia patients (p < 0.004). Conclusion Metabolic signature of persistent hyposmia after COVID-19 encompasses cortical regions involved in olfactory perception and does not overlap metabolic correlates of hyposmia in PD.
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Affiliation(s)
- Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genova, Italy. .,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy.
| | - Silvia Chiola
- Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, Rozzano, 20089, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Italy
| | - Maria Isabella Donegani
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Dario Arnaldi
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, 516126, Genoa, Italy
| | - Matteo Pardini
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, 516126, Genoa, Italy
| | - Raffaele Mancini
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, 516126, Genoa, Italy
| | - Francesco Lanfranchi
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Francesca D'amico
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alberto Miceli
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Erica Biassoni
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, 516126, Genoa, Italy
| | - Beatrice Orso
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, 516126, Genoa, Italy
| | - Emanuela Barisione
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luana Benedetti
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, 516126, Genoa, Italy
| | - Sambuceti Gianmario
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Flavio Nobili
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, 516126, Genoa, Italy
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7
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Bauckneht M, Chiola S, Donegani MI, Raffa S, Miceli A, Ferrarazzo G, Morbelli S. Central Nervous System Imaging in Movement Disorders. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00095-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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8
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Lanfranchi F, D'Amico F, Raffa S, Pennone M, Donegani MI, Miceli A, Chiola S, Maggio S, Delucchi C, Cossu V, Morbelli S, Bauckneht M, Sambuceti G, Marini C. Spleen Perfusion as an Index of Gender Impact on Sympathetic Nervous System Response to Exercise. Front Physiol 2021; 12:780713. [PMID: 34975534 PMCID: PMC8715039 DOI: 10.3389/fphys.2021.780713] [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: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: Sympathetic nervous system (SNS) reaction to exercise is gender dependent. Nevertheless, clinically applicable methods to identify this difference are still missing. An organ largely sensitive to SNS is the spleen whose response to exercise can be easily evaluated, being included in the field of view of myocardial perfusion imaging (MPI). Here, we aimed to verify whether gender interferes with the spleen perfusion and its response to exercise. Methods: For this purpose, we evaluated 286 original scans of consecutive patients submitted to MPI in the course of 2019. Our standard procedure implies a single-day stress-rest sequence with a gap of ≥2 h between the administrations of 180 and 500 MBq of 99mTc-Sestamibi, respectively. Imaging is performed 30 min after radiotracer administration, with scan duration set at 25 and 35 s per view, respectively. Non-gated scans were reconstructed with the filtered back-projection method. A volume of interest was drawn on the spleen and heart to estimate the dose-normalized average counting rate that was expressed in normalized counts per seconds (NCPS). Results: In all subjects submitted to exercise MPI (n = 228), NCPS were higher during stress than at rest (3.52 ± 2.03 vs. 2.78 ± 2.07, respectively; p < 0.01). This effect was not detected in the 58 patients submitted to dipyridamole-stress. The response to exercise selectively involved the spleen, since NCPS in heart were unchanged irrespective of the used stressor. This same response was dependent upon gender, indeed spleen NCPS during stress were significantly higher in the 75 women than in the 153 men (3.86 ± 1.8 vs. 3.23 ± 1.6, respectively, p < 0.01). Again, this variance was not reproduced by heart. Finally, spleen NCPS were lower in the 173 patients with myocardial reversible perfusion defects (summed difference score ≥3) than in the remaining 55, despite similar values of rate pressure product at tracer injection. Conclusion: Thus, exercise interference on spleen perfusion can be detected during MPI. This effect is dependent upon gender and ischemia confirming the high sensitivity of this organ to SNS activation.
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Affiliation(s)
- Francesco Lanfranchi
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Francesca D'Amico
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Stefano Raffa
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | | | - Alberto Miceli
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Chiola
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sara Maggio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Vanessa Cossu
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Gianmario Sambuceti
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cecilia Marini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), Milan, Italy
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9
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Donegani MI, Raffa S, Miceli A, Morbelli S, Bauckneht M. Increased 68 Ga-PSMA-11 Bone Marrow and Splenic Uptake in a Case of Erythroid Myelodysplasia. Nucl Med Mol Imaging 2021; 55:323-324. [PMID: 34868383 DOI: 10.1007/s13139-021-00718-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/08/2021] [Accepted: 10/05/2021] [Indexed: 12/01/2022] Open
Abstract
We describe the case of an 82-year-old man who underwent 68 Ga-prostate-specific membrane antigen-11 (68 Ga-PSMA-11) positron emission tomography/computed tomography (PET/CT) for the restaging of prostate carcinoma. 68 Ga-PSMA-11 PET/CT unexpectedly showed increased tracer uptake homogenously involving the axial and appendicular bone marrow and the spleen, not characteristic for metastatic prostate disease. Further investigations revealed that 2 months before the patient underwent bone marrow biopsy, which showed the occurrence of monolinear myelodysplasia.
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Affiliation(s)
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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10
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Bauckneht M, Bertagna F, Donegani MI, Durmo R, Miceli A, De Biasi V, Laudicella R, Fornarini G, Berruti A, Baldari S, Versari A, Giubbini R, Sambuceti G, Morbelli S, Albano D. The prognostic power of 18F-FDG PET/CT extends to estimating systemic treatment response duration in metastatic castration-resistant prostate cancer (mCRPC) patients. Prostate Cancer Prostatic Dis 2021; 24:1198-1207. [PMID: 34012060 PMCID: PMC8616756 DOI: 10.1038/s41391-021-00391-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/16/2021] [Accepted: 04/30/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND We aimed to test whether the prognostic value of 18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) in metastatic castration-resistant prostate cancer (mCRPC) extends to the estimation of systemic treatment response duration. METHODS mCRPC patients submitted to FDG-PET/CT in four Italian centers from 2005 to 2020 were retrospectively enrolled. Clinical and biochemical data at the time of imaging were collected, and SUV max of the hottest lesion, total metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated. The correlation between PET- and biochemical-derived parameters with Overall Survival (OS) was analysed. The prediction of treatment response duration was assessed in the subgroup submitted to FDG-PET/CT in the six months preceding Chemotherapy (namely Docetaxel or Cabazitaxel, 24 patients) or Androgen-Receptor Targeted Agents (ARTA, namely Abiraterone or Enzalutamide, 20 patients) administration. RESULTS We enrolled 114 mCRPC patients followed-up for a median interval lasting 15 months. While at univariate analysis, prostate-specific antigen (PSA), Alkaline Phosphatase (ALP), MTV, and TLG were associated with OS, at the multivariate Cox regression analysis, the sole MTV could independently predict OS (p < 0.0001). In the subgroup submitted to FDG-PET/CT before the systemic treatment initiation, PSA and TLG could also predict treatment response duration independently (p < 0.05). Of note, while PSA could not indicate the best treatment choice, lower TLG was associated with higher success rates for ARTA but had no impact on chemotherapy efficacy. CONCLUSIONS FDG-PET/CT's prognostic value extends to predicting treatment response duration in mCRPC, thus potentially guiding the systemic treatment selection.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
| | - Francesco Bertagna
- Nuclear Medicine, Spedali Civili of Brescia and University of Brescia, Brescia, Italy
| | - Maria Isabella Donegani
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Rexhep Durmo
- Nuclear Medicine, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Miceli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | | | - Riccardo Laudicella
- Nuclear Medicine, Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, University of Messina, Messina, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alfredo Berruti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology Unit, Università degli Studi di Brescia, ASST Spedali Civili, Brescia, Italy
| | - Sergio Baldari
- Nuclear Medicine, Department of Biomedical and Dental Sciences and of Morpho-functional Imaging, University of Messina, Messina, Italy
| | - Annibale Versari
- Nuclear Medicine, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Raffaele Giubbini
- Nuclear Medicine, Spedali Civili of Brescia and University of Brescia, Brescia, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Domenico Albano
- Nuclear Medicine, Spedali Civili of Brescia and University of Brescia, Brescia, Italy
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11
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Laudicella R, Bauckneht M, Cuppari L, Donegani MI, Arnone A, Baldari S, Burger IA, Quartuccio N. Emerging applications of imaging in glioma: focus on PET/MRI and radiomics. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00464-7] [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: 02/07/2023]
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12
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Miceli A, Riondato M, D’Amico F, Donegani MI, Piol N, Mora M, Spina B, Morbelli S, Bauckneht M. Concomitant Prostate Cancer and Hodgkin Lymphoma: A Differential Diagnosis Guided by a Combined 68Ga-PSMA-11 and 18F-FDG PET/CT Approach. Medicina (Kaunas) 2021; 57:975. [PMID: 34577898 PMCID: PMC8466493 DOI: 10.3390/medicina57090975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
Here we report the case of concomitant favorable-risk prostate cancer and Hodgkin Lymphoma in a 38-year old male. 68Ga-Prostate Specific Membrane Antigen-11 Positron Emission Tomography/Computed Tomography (68Ga-PSMA-11 PET/CT) was performed for staging purposes, showing the focal PSMA prostatic uptake as well as the presence of enlarged low-PSMA expressing mediastinal lymphadenopathies, thus raising the suspicion of another malignancy. A subsequent 18F-Fluorodeoxyglucose (18F-FDG) PET/CT demonstrated a high FDG-avidity by mediastinal lymphadenopathies as opposed to the low prostate cancer FDG uptake. Of note, both tumor entities were clearly detected by the two scans. However, different ranges in terms of Maximum Standardized Uptake Value (SUVmax) uptake allowed the discrimination between the two tumor entities. At the subsequent mediastinal lymph nodal biopsy, the coexistence of Hodgkin lymphoma was documented. The present case suggests that even if specific for prostate cancer, 68Ga-PSMA-11 PET/CT may raise the suspicion of other concurrent malignancies thanks to its non-receptor bounding mechanism. Further, it shows that in certain cases, the combination of 18F-FDG and 68Ga-PSMA PET/CT imaging may non-invasively guide the clinical management, optimizing the diagnostic process and the subsequent therapeutic interventions.
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Affiliation(s)
- Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (A.M.); (F.D.); (M.I.D.)
| | - Mattia Riondato
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.R.); (M.B.)
| | - Francesca D’Amico
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (A.M.); (F.D.); (M.I.D.)
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (A.M.); (F.D.); (M.I.D.)
| | - Nataniele Piol
- Division of Pathology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (N.P.); (M.M.); (B.S.)
| | - Marco Mora
- Division of Pathology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (N.P.); (M.M.); (B.S.)
| | - Bruno Spina
- Division of Pathology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (N.P.); (M.M.); (B.S.)
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (A.M.); (F.D.); (M.I.D.)
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.R.); (M.B.)
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (M.R.); (M.B.)
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13
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Bauckneht M, Rebuzzi SE, Signori A, Frantellizzi V, Murianni V, Lodi Rizzini E, Mascia M, Lavelli V, Donegani MI, Ponzano M, Gaudiano A, Stazza ML, Licari M, Cavallini L, Laghi V, Cindolo L, Maggi M, Sciarra A, Mammucci P, Sambuceti G, Costa RP, Spanu A, Rubini G, Monari F, De Vincentis G, Fornarini G. The prognostic power of inflammatory indices and clinical factors in metastatic castration-resistant prostate cancer patients treated with radium-223 (BIO-Ra study). Eur J Nucl Med Mol Imaging 2021; 49:1063-1074. [PMID: 34486070 PMCID: PMC8803683 DOI: 10.1007/s00259-021-05550-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 06/03/2021] [Accepted: 08/29/2021] [Indexed: 01/04/2023]
Abstract
Purpose To combine peripheral blood indices and clinical factors in a prognostic score for metastatic castration-resistant prostate cancer (mCRPC) patients treated with radium-223 dichloride ([223Ra]RaCl2). Patients and methods Baseline neutrophil-to-lymphocyte ratio (NLR), derived NLR (donor), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), Eastern Cooperative Oncology Group performance status (ECOG PS), Gleason score (GS) group, number of bone metastases, prostate-specific antigen (PSA), alkaline phosphatase (ALP), line of therapy, previous chemotherapy, and the presence of lymphadenopathies were collected from seven Italian centers between 2013 and 2020. Lab and clinical data were assessed in correlation with the overall survival (OS). Inflammatory indices were then included separately in the multivariable analyses with the prognostic clinical factors. The model with the highest discriminative ability (c-index) was chosen to develop the BIO-Ra score. Results Five hundred and nineteen mCRPC patients (median OS: 19.9 months) were enrolled. Higher NLR, dNLR, PLR, and SII and lower LMR predicted worse OS (all with a p < 0.001). The multivariable model including NLR, ECOG PS, number of bone metastases, ALP, and PSA (c-index: 0.724) was chosen to develop the BIO-Ra score. Using the Schneeweiss scoring system, the BIO-Ra score identified three prognostic groups (36%, 27.3%, and 36.6% patients, respectively) with distinct median OS (31, 26.6, and 9.6 months, respectively; hazard ratio: 1.62, p = 0.008 for group 2 vs. 1 and 5.77, p < 0.001 for group 3 vs. 1). Conclusions The BIO-Ra score represents an easy and widely applicable tool for the prognostic stratification of mCRPC patients treated with [223Ra]RaCl2 with no additional costs. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05550-6.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy. .,Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
| | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Viviana Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Veronica Murianni
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties, University of Genova, Genova, Italy
| | - Elisa Lodi Rizzini
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Manlio Mascia
- Unit of Nuclear Medicine, Spirito Santo Hospital, Pescara, Italy
| | - Valentina Lavelli
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Isabella Donegani
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Marta Ponzano
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Angela Gaudiano
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Lina Stazza
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria Licari
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Letizia Cavallini
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.,Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum Bologna University, Bologna, Italy
| | - Viola Laghi
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.,Department of Experimental Diagnostic and Specialty Medicine, Alma Mater Studiorum Bologna University, Bologna, Italy
| | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
| | - Martina Maggi
- Department of Urology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Alessandro Sciarra
- Department of Urology, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Paolo Mammucci
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Renato Patrizio Costa
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giuseppe Rubini
- Nuclear Medicine Section, Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Fabio Monari
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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14
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Marini C, Cossu V, Kumar M, Milanese M, Cortese K, Bruno S, Bellese G, Carta S, Zerbo RA, Torazza C, Bauckneht M, Venturi C, Raffa S, Orengo AM, Donegani MI, Chiola S, Ravera S, Castellani P, Morbelli S, Sambuceti G, Bonanno G. The Role of Endoplasmic Reticulum in the Differential Endurance against Redox Stress in Cortical and Spinal Astrocytes from the Newborn SOD1 G93A Mouse Model of Amyotrophic Lateral Sclerosis. Antioxidants (Basel) 2021; 10:antiox10091392. [PMID: 34573024 PMCID: PMC8472526 DOI: 10.3390/antiox10091392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 12/01/2022] Open
Abstract
Recent studies reported that the uptake of [18F]-fluorodeoxyglucose (FDG) is increased in the spinal cord (SC) and decreased in the motor cortex (MC) of patients with ALS, suggesting that the disease might differently affect the two nervous districts with different time sequence or with different mechanisms. Here we show that MC and SC astrocytes harvested from newborn B6SJL-Tg (SOD1G93A) 1Gur mice could play different roles in the pathogenesis of the disease. Spectrophotometric and cytofluorimetric analyses showed an increase in redox stress, a decrease in antioxidant capacity and a relative mitochondria respiratory uncoupling in MC SOD1G93A astrocytes. By contrast, SC mutated cells showed a higher endurance against oxidative damage, through the increase in antioxidant defense, and a preserved respiratory function. FDG uptake reproduced the metabolic response observed in ALS patients: SOD1G93A mutation caused a selective enhancement in tracer retention only in mutated SC astrocytes, matching the activity of the reticular pentose phosphate pathway and, thus, of hexose-6P dehydrogenase. Finally, both MC and SC mutated astrocytes were characterized by an impressive ultrastructural enlargement of the endoplasmic reticulum (ER) and impairment in ER–mitochondria networking, more evident in mutated MC than in SC cells. Thus, SOD1G93A mutation differently impaired MC and SC astrocyte biology in a very early stage of life.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), Segrate, 20054 Milan, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.B.); (A.M.O.); (S.C.); (S.M.); (G.S.)
- Correspondence:
| | - Vanessa Cossu
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (V.C.); (S.R.); (M.I.D.)
| | - Mandeep Kumar
- Department of Pharmacy, Section of Pharmacology and Toxicology, University of Genoa, 16148 Genoa, Italy; (M.K.); (M.M.); (R.A.Z.); (C.T.); (G.B.)
| | - Marco Milanese
- Department of Pharmacy, Section of Pharmacology and Toxicology, University of Genoa, 16148 Genoa, Italy; (M.K.); (M.M.); (R.A.Z.); (C.T.); (G.B.)
| | - Katia Cortese
- Department of Experimental Medicine, Human Anatomy, University of Genoa, 16132 Genoa, Italy; (K.C.); (S.B.); (G.B.); (C.V.); (S.R.)
| | - Silvia Bruno
- Department of Experimental Medicine, Human Anatomy, University of Genoa, 16132 Genoa, Italy; (K.C.); (S.B.); (G.B.); (C.V.); (S.R.)
| | - Grazia Bellese
- Department of Experimental Medicine, Human Anatomy, University of Genoa, 16132 Genoa, Italy; (K.C.); (S.B.); (G.B.); (C.V.); (S.R.)
| | - Sonia Carta
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (P.C.)
| | - Roberta Arianna Zerbo
- Department of Pharmacy, Section of Pharmacology and Toxicology, University of Genoa, 16148 Genoa, Italy; (M.K.); (M.M.); (R.A.Z.); (C.T.); (G.B.)
| | - Carola Torazza
- Department of Pharmacy, Section of Pharmacology and Toxicology, University of Genoa, 16148 Genoa, Italy; (M.K.); (M.M.); (R.A.Z.); (C.T.); (G.B.)
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.B.); (A.M.O.); (S.C.); (S.M.); (G.S.)
| | - Consuelo Venturi
- Department of Experimental Medicine, Human Anatomy, University of Genoa, 16132 Genoa, Italy; (K.C.); (S.B.); (G.B.); (C.V.); (S.R.)
| | - Stefano Raffa
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (V.C.); (S.R.); (M.I.D.)
| | - Anna Maria Orengo
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.B.); (A.M.O.); (S.C.); (S.M.); (G.S.)
| | - Maria Isabella Donegani
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (V.C.); (S.R.); (M.I.D.)
| | - Silvia Chiola
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.B.); (A.M.O.); (S.C.); (S.M.); (G.S.)
| | - Silvia Ravera
- Department of Experimental Medicine, Human Anatomy, University of Genoa, 16132 Genoa, Italy; (K.C.); (S.B.); (G.B.); (C.V.); (S.R.)
| | - Patrizia Castellani
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (P.C.)
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.B.); (A.M.O.); (S.C.); (S.M.); (G.S.)
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (V.C.); (S.R.); (M.I.D.)
| | - Gianmario Sambuceti
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), Segrate, 20054 Milan, Italy
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.B.); (A.M.O.); (S.C.); (S.M.); (G.S.)
| | - Giambattista Bonanno
- Department of Pharmacy, Section of Pharmacology and Toxicology, University of Genoa, 16148 Genoa, Italy; (M.K.); (M.M.); (R.A.Z.); (C.T.); (G.B.)
- Pharmacology and Toxycology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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15
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Rebuzzi SE, Bauckneht M, Signori A, Frantellizzi V, Lodi Rizzini E, Mascia M, Lavelli V, Stazza ML, Licari M, Donegani MI, Ponzano M, Cavallini L, Laghi V, Cindolo L, Costa RP, Spanu A, Rubini G, Monari F, De Vincentis G, Fornarini G. Prognostic role of inflammatory biomarkers from peripheral blood and clinical factors in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with radium-223 (Ra-223) (BIO-Ra-223 study). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e17026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17026 Background: Ra-223 is a treatment option for mCRPC pts with bone metastases according to the survival benefit observed compared to placebo in the ALSYMPCA trial. In the last years, many studies showed this benefit in the real-life pts is lower than that reported in the trial, probably due to a suboptimal selection of pts with poor prognostic characteristics. Therefore, the identification of prognostic factors to select mCRPC pts most likely to benefit from Ra-223 is needed. The multicentre retrospective BIO-Ra-223 study has investigated the prognostic role of peripheral blood immune cells and clinical factors to develop a novel prognostic score for mCRPC pts treated with Ra-223. Methods: Complete blood count was assessed before Ra-223 treatment calculating neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII). Clinical factors included pre-treatment Eastern Cooperative Oncology Group performance status (ECOG PS), Gleason Score (GS) group, number of bone metastases, alkaline phosphatase (ALP), line of therapy, previous chemotherapy and the presence of lymphadenopathies. Statistical analyses included survival ROC curves for biomarkers’ cutoffs, univariable and multivariable Cox analyses, internal validation, c-index calculation and Schneeweiss scoring system. Results: From September 2013 to July 2020, 519 mCRPC pts received Ra-223 as 1st-2nd, 3rd-4th and further-line in 48%, 38% and 14% of pts. The median overall survival (mOS) of the entire cohort was 19.9 months. All biomarkers and clinical factors (except for GS group) significantly predicted OS at the univariable analyses. In the multivariable ones, all biomarkers, ECOG PS, number of bone metastases and ALP significantly correlated with OS. The multivariable model with NLR (< 3.1 vs ≥3.1), ECOG PS (0-1 vs 2-3), number of bone metastases (< 6, 6-20, > 20) and ALP (< 220 vs ≥220) showed the highest c-index (0.711), which was maintained after internal validation (bootstrap re-sampling) (c-index: 0.707). Using the Schneeweiss scoring system, ten categories were identified in 494 pts with complete data and merged in two prognostic groups with distinctive OSs: group 1 (score 0-4, 337 pts) with a mOS of 27.8 months and group 2 (score 5-10, 157 pts) with a mOS of 9.7 months (HR 4.03, p < 0.001). Conclusions: The obtained score, composed of NLR, ECOG PS, number of bone metastases, and ALP identifies two distinctive prognostic groups of mCRPC pts. Moreover, this score is easily and widely applicable for clinical practice and trials at no additional costs. Although external validation is needed, these preliminary results showed that this novel prognostic score is promising and could help the patients’ selection for Ra-223 treatment.
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Affiliation(s)
- Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genoa, Genoa, Italy
| | - Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences, Section of Biostatistics, University of Genoa, Genoa, Italy
| | | | - Elisa Lodi Rizzini
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Manlio Mascia
- Unit of Nuclear Medicine, Spirito Santo Hospital, Pescara, Italy
| | - Valentina Lavelli
- Nuclear Medicine Department, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Lina Stazza
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria Licari
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Maria Isabella Donegani
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Marta Ponzano
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Letizia Cavallini
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Department of Experimental Diagnostic and Specialty Medicine-Alma Mater Studiorum Bologna University, Bologna, Italy
| | - Viola Laghi
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Department of Experimental Diagnostic and Specialty Medicine-Alma Mater Studiorum Bologna University, Bologna, Italy
| | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
| | - Renato Patrizio Costa
- Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giuseppe Rubini
- Nuclear Medicine Department, University of Bari "Aldo Moro", Bari, Italy
| | - Fabio Monari
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Ricciardi E, Moscatelli A, Berruti M, Donegani MI, Mikulska MK, Pende A. 18F-Fluorodeoxyglucose positron emission tomography/computed tomography as a diagnostic and follow-up tool in Coxiella burnetii endocarditis of prosthetic valve and aortic valved tube: a case report. Eur Heart J Case Rep 2021; 5:ytab159. [PMID: 34027304 PMCID: PMC8127028 DOI: 10.1093/ehjcr/ytab159] [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] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/26/2020] [Accepted: 04/09/2021] [Indexed: 11/14/2022]
Abstract
Background European Society of Cardiology 2015 guidelines approved 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) as a useful diagnostic imaging technique in prosthetic valve endocarditis (PVE) and recent evidence seems to suggest a role of nuclear imaging in the follow-up of cardiovascular infections, but nowadays there are no sufficient data available. Case summary A 67-year-old male presented with fever, weight loss, and fatigue. His medical history included ulcerative colitis and a previous Bentall-De Bono surgical procedure in 2014. A previous recent hospitalization to a small community hospital did not reveal a clear aetiology for the fever: transeosophageal echocardiography showed dubious peri-prosthetic tissue alterations, interpreted as post-surgical fibrosis; consequently, the patient was discharged with steroid therapy. At admission in our ward, we repeated transoesophageal echocardiography that confirmed the peri-prosthetic alterations. Moreover, 18F-FDG PET/CT showed two hypermetabolic areas, one around the prosthetic tube in the aortic bulb and the other in relation with the prosthetic aortic valve. Serological test was positive for Coxiella burnetii infection with consequent beginning of a targeted antimicrobial therapy with oral doxicycline and hydroxychloroquine. Echocardiography, serology, and 18F-FDG PET/CT follow-up demonstrated a progressive response to treatment and clinical conditions of the patient gradually improved. Discussion According to guidelines, 18F-FDG PET/CT can be used in ambiguous PVE to improve diagnostic accuracy of standard techniques. In this case, 18F-FDG PET/CT combined with echocardiography and serological tests is used not only to better define diagnosis but also for treatment response monitoring during follow-up.
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Affiliation(s)
- Elisa Ricciardi
- Clinic of Emergency Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alessandro Moscatelli
- Division of Gastroenterology and Digestive Endoscopy, Hospital of Lavagna ASL4 Chiavarese, Lavagna, Italy
| | - Marco Berruti
- Clinic of Infective Diseases, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Isabella Donegani
- Division of Nuclear Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Aldo Pende
- Clinic of Emergency Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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17
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Bauckneht M, Raffa S, Leale G, Sambuceti V, De Cesari M, Donegani MI, Marini C, Drakonaki E, Orlandi D. Molecular imaging in MSK radiology: Where are we going? Eur J Radiol 2021; 140:109737. [PMID: 33951567 DOI: 10.1016/j.ejrad.2021.109737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/18/2021] [Accepted: 04/25/2021] [Indexed: 11/15/2022]
Abstract
Musculoskeletal (MSK) pathologies are one of the leading causes of disability worldwide. However, treatment options and understanding of pathogenetic processes are still partially unclear, mainly due to a limited ability in early disease detection and response to therapy assessment. In this scenario, thanks to a strong technological advancement, structural imaging is currently established as the gold-standard of diagnosis in many MSK disorders but each single diagnostic modality (plain films, high-resolution ultrasound, computed tomography and magnetic resonance) still suffer by a low specificity regarding the characterization of inflammatory processes, the quantification of inflammatory activity levels, and the degree of response to therapy. To overcome these limitations, molecular imaging techniques may play a promising role. Starting from the strengths and weaknesses of structural anatomical imaging, the present narrative review aims to highlight the promising role of molecular imaging in the assessment of non-neoplastic MSK diseases with a special focus on its role to monitor treatment response.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Sciences (DISSAL), Genoa University, Genoa, Italy
| | - Stefano Raffa
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Sciences (DISSAL), Genoa University, Genoa, Italy
| | - Giacomo Leale
- Private MSK Imaging Institution, Heraklion, Crete, Greece & European University of Cyprus Medical School, Nicosia, Cyprus
| | - Virginia Sambuceti
- Postgraduate School of Radiology, Genoa University, Via Alberti 4, 16132, Genoa, Italy
| | | | - Maria Isabella Donegani
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Sciences (DISSAL), Genoa University, Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), Segrate (MI), Italy
| | - Eleni Drakonaki
- Private MSK Imaging Institution, Heraklion, Crete, Greece & European University of Cyprus Medical School, Nicosia, Cyprus
| | - Davide Orlandi
- Department of Radiology, Ospedale Evangelico Internazionale, Corso Solferino, 1a, 16122, Genoa, Italy.
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18
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Bauckneht M, Chincarini A, Brendel M, Rominger A, Beyer L, Bruffaerts R, Vandenberghe R, Kramberger MG, Trost M, Garibotto V, Nicastro N, Frisoni GB, Lemstra AW, van Berckel BNM, Pilotto A, Padovani A, Ochoa-Figueroa MA, Davidsson A, Camacho V, Peira E, Arnaldi D, Pardini M, Donegani MI, Raffa S, Miceli A, Sambuceti G, Aarsland D, Nobili F, Morbelli S. Associations among education, age, and the dementia with Lewy bodies (DLB) metabolic pattern: A European-DLB consortium project. Alzheimers Dement 2021; 17:1277-1286. [PMID: 33528089 DOI: 10.1002/alz.12294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION We assessed the influence of education as a proxy of cognitive reserve and age on the dementia with Lewy bodies (DLB) metabolic pattern. METHODS Brain 18F-fluorodeoxyglucose positron emission tomography and clinical/demographic information were available in 169 probable DLB patients included in the European DLB-consortium database. Principal component analysis identified brain regions relevant to local data variance. A linear regression model was applied to generate age- and education-sensitive maps corrected for Mini-Mental State Examination score, sex (and either education or age). RESULTS Age negatively covaried with metabolism in bilateral middle and superior frontal cortex, anterior and posterior cingulate, reducing the expression of the DLB-typical cingulate island sign (CIS). Education negatively covaried with metabolism in the left inferior parietal cortex and precuneus (making the CIS more prominent). DISCUSSION These findings point out the importance of tailoring interpretation of DLB biomarkers considering the concomitant effect of individual, non-disease-related variables such as age and cognitive reserve.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Chincarini
- National Institute of Nuclear Physics (INFN), Genoa Section, Genoa, Italy
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.,Department of Nuclear Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Rose Bruffaerts
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Neurology Department, University Hospitals Leuven, Leuven, Belgium.,Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Milica G Kramberger
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Trost
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals and NIMTLab, Geneva University, Geneva, Switzerland
| | - Nicolas Nicastro
- Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.,Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Giovanni B Frisoni
- LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Bart N M van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Parkinson's Disease Rehabilitation Centre, FERB ONLUS-S, Isidoro Hospital, Trescore Balneario, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Miguel A Ochoa-Figueroa
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Diagnostic Radiology, Linköping University Hospital, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Anette Davidsson
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Valle Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enrico Peira
- National Institute of Nuclear Physics (INFN), Genoa Section, Genoa, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Stefano Raffa
- Department of Health Sciences, University of Genoa, Italy
| | - Alberto Miceli
- Department of Health Sciences, University of Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences, University of Genoa, Italy
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.,Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences, University of Genoa, Italy
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Brugnolo A, Girtler N, Doglione E, Orso B, Massa F, Donegani MI, Bauckneht M, Morbelli S, Arnaldi D, Nobili F, Pardini M. Brain Resources: How Semantic Cueing Works in Mild Cognitive Impairment due to Alzheimer's Disease (MCI-AD). Diagnostics (Basel) 2021; 11:diagnostics11010108. [PMID: 33445437 PMCID: PMC7826532 DOI: 10.3390/diagnostics11010108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/23/2020] [Accepted: 01/04/2021] [Indexed: 11/25/2022] Open
Abstract
Semantic cues in the Free and Cued Selective Reminding Test (FCRST) play a key role in the neuropsychological diagnosis of Amnesic Mild Cognitive Impairment due to Alzheimer’s Disease (MCI-AD); however, the neural bases of their impact of recall abilities are only partially understood. Here, we thus decided to investigate the relationships between brain metabolism and the FCSRT Index of Sensitivity of Cueing (ISC) in patients with MCI-AD and in healthy controls (HC). Materials: Thirty MCI-AD patients (age: 74.7 ± 5.7 years; education: 9.6 ± 4.6 years, MMSE score: 24.8 ± 3.3, 23 females) and seventeen HC (age: 66.5 ± 11.1 years; education: 11.53 ± 4.2 years, MMSE score: 28.4 ± 1.14, 10 females) who underwent neuropsychological evaluation and brain F-18 fluorodeoxyglucose Positron Emission Tomography (FDG-PET) were included in the study. Results: ISC was able to differentiate HC from MCI-AD subjects as shown by a ROC analysis (AUC of 0.978, effect size Hedges’s g = 2.89). MCI-AD subjects showed significant hypometabolism in posterior cortices, including bilateral inferior Parietal Lobule and Precuneus and Middle Temporal gyrus in the left hemisphere (VOI-1) compared to HC. ISC was positively correlated with brain metabolism in a single cluster (VOI-2) spanning the left prefrontal cortex (superior frontal gyrus) and anterior cingulate cortex (ACC) in the patient group (R2 = 0.526, p < 0.001), but not in HC. Mean uptake values of VOI-2 did not differ between HC and MCI-AD. The structural connectivity analysis showed that VOI-2 is connected with the temporal pole, the cingulate gyrus and the posterior temporal cortices in the left hemisphere. Conclusion: In MCI-AD, the relative preservation of frontal cortex metabolic levels and their correlation with the ISC suggest that the left frontal cortices play a significant role in maintaining a relatively good memory performance despite the presence of posterior hypometabolism in MCI-AD.
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Affiliation(s)
- Andrea Brugnolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
- Clinical Psychology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-010-353778
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
- Clinical Psychology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Elisa Doglione
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
| | - Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (M.I.D.); (M.B.); (S.M.)
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (M.I.D.); (M.B.); (S.M.)
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (M.I.D.); (M.B.); (S.M.)
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
- Neurology Clinics, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
- Neurology Clinics, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child health (DINOGMI), University of Genoa, 16132 Genova, Italy; (N.G.); (E.D.); (B.O.); (F.M.); (D.A.); (F.N.); (M.P.)
- Neurology Clinics, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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20
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Arnaldi D, Famà F, Girtler N, Brugnolo A, Pardini M, Mattioli P, Meli R, Massa F, Orso B, Sormani MP, Donegani MI, Bauckneht M, Morbelli S, Nobili F. Rapid eye movement sleep behavior disorder: A proof-of-concept neuroprotection study for prodromal synucleinopathies. Eur J Neurol 2020; 28:1210-1217. [PMID: 33275819 DOI: 10.1111/ene.14664] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/19/2020] [Accepted: 11/26/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE To explore the feasibility of a neuroprotection trial in prodromal synucleinopathy, using idiopathic rapid eye movement sleep behavior disorder (iRBD) as the target population and 123 I-FP-CIT-SPECT as a biomarker of disease progression. METHODS Consecutive iRBD patients were randomly assigned to a treatment arm receiving selegiline and symptomatic rapid eye movement sleep behavior disorder treatment, or to a control arm receiving symptomatic treatment only. Selegiline was chosen because of a demonstrated neuroprotection effect in animal models. Patients underwent 123 I-FP-CIT-SPECT at baseline and after 30 months on average. The clinical outcome was the emergence of parkinsonism and/or dementia. A repeated-measures general linear model (GLM) was applied using group (control and treatment) as "between" factor, and both time (baseline and follow-up) and regions (123 I-FP-CIT-SPECT putamen and caudate uptake) as the "within" factors, adjusting for age. RESULTS Thirty iRBD patients completed the study (68.2 ± 6.9 years; 29 males; 21% dropout rate), 13 in the treatment arm, and 17 in the control arm. At follow-up (29.8 ± 9.0 months), three patients in the control arm developed dementia and one parkinsonism, whereas two patients in the treatment arm developed parkinsonism. Both putamen and caudate uptake decreased over time in the control arm. In the treatment arm, only the putamen uptake decreased over time, whereas caudate uptake remained stable. GLM analysis demonstrated an effect of treatment on the 123 I-FP-CIT-SPECT uptake change, with a significant interaction between the effect of group, time, and regions (p = 0.004). CONCLUSIONS A 30-months neuroprotection study for prodromal synucleinopathy is feasible, using iRBD as the target population and 123 I-FP-CIT-SPECT as a biomarker of disease progression.
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Affiliation(s)
- Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Famà
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicola Girtler
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Brugnolo
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pietro Mattioli
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Riccardo Meli
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Massa
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Beatrice Orso
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy
| | | | - Maria Isabella Donegani
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Nuclear Medicine, Department of Health Sciences (DISSAL, University of Genoa, Genoa, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Nuclear Medicine, Department of Health Sciences (DISSAL, University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Nuclear Medicine, Department of Health Sciences (DISSAL, University of Genoa, Genoa, Italy
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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21
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Morbelli S, Arnaldi D, Cella E, Raffa S, Donegani MI, Capitanio S, Massa F, Miceli A, Filippi L, Chincarini A, Nobili F. Striatal dopamine transporter SPECT quantification: head-to-head comparison between two three-dimensional automatic tools. EJNMMI Res 2020; 10:137. [PMID: 33159607 PMCID: PMC7648825 DOI: 10.1186/s13550-020-00727-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/28/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose Our aim was to compare a widely distributed commercial tool with an older free software (i) one another, (ii) with a clinical motor score, (iii) versus reading by experts. Procedures We analyzed consecutive scans from one-hundred and fifty-one outpatients submitted to brain DAT SPECT for a suspected parkinsonism. Images were post-processed using a commercial (Datquant®) and a free (BasGanV2) software. Reading by expert was the gold standard. A subset of patients with pathological or borderline scan was evaluated with the clinical Unified Parkinson’s Disease Rating Scale, motor part (MDS-UPDRS-III). Results SBR, putamen-to-caudate (P/C) ratio, and both P and C asymmetries were highly correlated between the two software with Pearson’s ‘r’ correlation coefficients ranging from .706 to .887. Correlation coefficients with the MDS-UPDRS III score were higher with caudate than with putamen SBR values with both software, and in general higher with BasGanV2 than with Datquant®. Datquant® correspondence with expert reading was 84.1% (94.0% by additionally considering the P/C ratio as a further index). BasGanV2 correspondence with expert reading was 80.8% (86.1% by additionally considering the P/C ratio). Conclusions Both Datquant® and BasGanV2 work reasonably well and similarly one another in semi-quantification of DAT SPECT. Both tools have their own strength and pitfalls that must be known in detail by users in order to obtain the best help in visual reading and reporting of DAT SPECT.
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Affiliation(s)
- Silvia Morbelli
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Dario Arnaldi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Eugenia Cella
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Stefano Raffa
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | | | | | - Federico Massa
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Alberto Miceli
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Laura Filippi
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Andrea Chincarini
- Genoa Section, National Institute of Nuclear Physics (INFN), Genoa, Italy
| | - Flavio Nobili
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.
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22
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Miceli A, Cossu V, Marini C, Castellani P, Raffa S, Donegani MI, Bruno S, Ravera S, Emionite L, Orengo AM, Grillo F, Nobili F, Morbelli S, Uccelli A, Sambuceti G, Bauckneht M. 18F-Fluorodeoxyglucose Positron Emission Tomography Tracks the Heterogeneous Brain Susceptibility to the Hyperglycemia-Related Redox Stress. Int J Mol Sci 2020; 21:ijms21218154. [PMID: 33142766 PMCID: PMC7672601 DOI: 10.3390/ijms21218154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022] Open
Abstract
In cognitively normal patients, mild hyperglycemia selectively decreases 18F-Fluorodeoxyglucose (FDG) uptake in the posterior brain, reproducing Alzheimer disease pattern, hampering the diagnostic accuracy of this widely used tool. This phenomenon might involve either a heterogeneous response of glucose metabolism or a different sensitivity to hyperglycemia-related redox stress. Indeed, previous studies reported a close link between FDG uptake and activation of a specific pentose phosphate pathway (PPP), triggered by hexose-6P-dehydrogenase (H6PD) and contributing to fuel NADPH-dependent antioxidant responses in the endoplasmic reticulum (ER). To clarify this issue, dynamic positron emission tomography was performed in 40 BALB/c mice four weeks after administration of saline (n = 17) or 150 mg/kg streptozotocin (n = 23, STZ). Imaging data were compared with biochemical and histological indexes of glucose metabolism and redox balance. Cortical FDG uptake was homogeneous in controls, while it was selectively decreased in the posterior brain of STZ mice. This difference was independent of the activity of enzymes regulating glycolysis and cytosolic PPP, while it was paralleled by a decreased H6PD catalytic function and enhanced indexes of oxidative damage. Thus, the relative decrease in FDG uptake of the posterior brain reflects a lower activation of ER-PPP in response to hyperglycemia-related redox stress in these areas.
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Affiliation(s)
- Alberto Miceli
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy; (A.M.); (V.C.); (S.R.); (M.I.D.); (S.M.); (G.S.)
| | - Vanessa Cossu
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy; (A.M.); (V.C.); (S.R.); (M.I.D.); (S.M.); (G.S.)
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (A.M.O.)
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20090 Milano, Italy
| | | | - Stefano Raffa
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy; (A.M.); (V.C.); (S.R.); (M.I.D.); (S.M.); (G.S.)
| | - Maria Isabella Donegani
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy; (A.M.); (V.C.); (S.R.); (M.I.D.); (S.M.); (G.S.)
| | - Silvia Bruno
- Department of Experimental Medicine, Human Anatomy, University of Genoa, Genova 16132, Italy; (S.B.); (S.R.)
| | - Silvia Ravera
- Department of Experimental Medicine, Human Anatomy, University of Genoa, Genova 16132, Italy; (S.B.); (S.R.)
| | - Laura Emionite
- Animal Facility, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Anna Maria Orengo
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (A.M.O.)
| | - Federica Grillo
- Department of Surgical Sciences and Integrated Diagnostics, Pathology Unit, University of Genoa, 16132 Genova, Italy;
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Center of Excellence for Biomedical Research, University of Genoa, 16132 Genoa, Italy; (F.N.); (A.U.)
- Clinical Neurology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Silvia Morbelli
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy; (A.M.); (V.C.); (S.R.); (M.I.D.); (S.M.); (G.S.)
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (A.M.O.)
| | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Center of Excellence for Biomedical Research, University of Genoa, 16132 Genoa, Italy; (F.N.); (A.U.)
- Clinical Neurology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianmario Sambuceti
- Department of Health Sciences, University of Genoa, 16132 Genova, Italy; (A.M.); (V.C.); (S.R.); (M.I.D.); (S.M.); (G.S.)
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (A.M.O.)
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (A.M.O.)
- Correspondence:
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23
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Bauckneht M, Rebuzzi SE, Signori A, Donegani MI, Murianni V, Miceli A, Borea R, Raffa S, Damassi A, Ponzano M, Catalano F, Martelli V, Marini C, Boccardo F, Morbelli S, Sambuceti G, Fornarini G. The Prognostic Role of Baseline Metabolic Tumor Burden and Systemic Inflammation Biomarkers in Metastatic Castration-Resistant Prostate Cancer Patients Treated with Radium-223: A Proof of Concept Study. Cancers (Basel) 2020; 12:cancers12113213. [PMID: 33142739 PMCID: PMC7693606 DOI: 10.3390/cancers12113213] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 09/30/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
Over the last years has emerged the urgent need for the identification of reliable prognostic biomarkers able to potentially identify metastatic castration-resistant prostate cancer (mCRPC) patients most likely to benefit from Radium-223 (Ra-223) since baseline. In the present monocentric retrospective study, we analyzed the prognostic power of systemic inflammation biomarkers and 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET)-derived parameters and their potential interplay in this clinical setting. The following baseline laboratory parameters were collected in 59 mCRPC patients treated with Ra-223: neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelets-to-lymphocyte ratio (PLR), and systemic inflammation index (SII), while maximum Standardized Uptake Value, Metabolic Tumor Volume (MTV), and Total Lesion Glycolysis (TLG) were calculated in the 48 of them submitted to baseline FDG-PET. At the univariate analysis, NLR, dNLR, MTV, and TLG were able to predict the overall survival (OS). However, only NLR and MTV were independent predictors of OS at the multivariate analysis. Additionally, the occurrence of both increased NLR and MTV at baseline identified mCRPC patients at higher risk for lower long-term survival after treatment with Ra-223. In conclusion, the degree of systemic inflammation, the quantification of the metabolically active tumor burden and their combination might represent potentially valuable tools for identifying mCRPC patients who are most likely to benefit from Ra-223. However, further studies are needed to reproduce these findings in larger settings.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Correspondence:
| | - Sara Elena Rebuzzi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Veronica Murianni
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Roberto Borea
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Alessandra Damassi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Marta Ponzano
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Fabio Catalano
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Valentino Martelli
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20090 Segrate (MI), Italy
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, 16132 Genova, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (C.M.); (S.M.); (G.S.)
- Department of Health Sciences (DISSAL), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (A.S.); (M.I.D.); (A.M.); (S.R.); (M.P.)
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (S.E.R.); (V.M.); (R.B.); (A.D.); (F.C.); (V.M.); (G.F.)
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24
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Marini C, Cossu V, Bonifacino T, Bauckneht M, Torazza C, Bruno S, Castellani P, Ravera S, Milanese M, Venturi C, Carlone S, Piccioli P, Emionite L, Morbelli S, Orengo AM, Donegani MI, Miceli A, Raffa S, Marra S, Signori A, Cortese K, Grillo F, Fiocca R, Bonanno G, Sambuceti G. Mechanisms underlying the predictive power of high skeletal muscle uptake of FDG in amyotrophic lateral sclerosis. EJNMMI Res 2020; 10:76. [PMID: 32638178 PMCID: PMC7340686 DOI: 10.1186/s13550-020-00666-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023] Open
Abstract
Background We recently reported that enhanced [18F]-fluorodeoxyglucose (FDG) uptake in skeletal muscles predicts disease aggressiveness in patients with amyotrophic lateral sclerosis (ALS). The present experimental study aimed to assess whether this predictive potential reflects the link between FDG uptake and redox stress that has been previously reported in different tissues and disease models. Methods The study included 15 SOD1G93A mice (as experimental ALS model) and 15 wildtype mice (around 120 days old). Mice were submitted to micro-PET imaging. Enzymatic pathways and response to oxidative stress were evaluated in harvested quadriceps and hearts by biochemical, immunohistochemical, and immunofluorescence analysis. Colocalization between the endoplasmic reticulum (ER) and the fluorescent FDG analog 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino]-2-deoxyglucose (2-NBDG) was performed in fresh skeletal muscle sections. Finally, mitochondrial ultrastructure and bioenergetics were evaluated in harvested quadriceps and hearts. Results FDG retention was significantly higher in hindlimb skeletal muscles of symptomatic SOD1G93A mice with respect to control ones. This difference was not explained by any acceleration in glucose degradation through glycolysis or cytosolic pentose phosphate pathway (PPP). Similarly, it was independent of inflammatory infiltration. Rather, the high FDG retention in SOD1G93A skeletal muscle was associated with an accelerated generation of reactive oxygen species. This redox stress selectively involved the ER and the local PPP triggered by hexose-6P-dehydrogenase. ER involvement was confirmed by the colocalization of the 2-NBDG with a vital ER tracker. The oxidative damage in transgenic skeletal muscle was associated with a severe impairment in the crosstalk between ER and mitochondria combined with alterations in mitochondrial ultrastructure and fusion/fission balance. The expected respiratory damage was confirmed by a deceleration in ATP synthesis and oxygen consumption rate. These same abnormalities were represented to a markedly lower degree in the myocardium, as a sample of non-voluntary striated muscle. Conclusion Skeletal muscle of SOD1G93A mice reproduces the increased FDG uptake observed in ALS patients. This finding reflects the selective activation of the ER-PPP in response to significant redox stress associated with alterations of mitochondrial ultrastructure, networking, and connection with the ER itself. This scenario is less severe in cardiomyocytes suggesting a relevant role for either communication with synaptic plaque or contraction dynamics.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), Milano, Italy. .,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132, Genova, Italy.
| | - Vanessa Cossu
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132, Genova, Italy.,Department of Health Sciences, University of Genoa, Genova, Italy
| | - Tiziana Bonifacino
- Department of Pharmacy, Section of Pharmacology and Toxicology and Center of Excellence for Biomedical Research, University of Genoa, Genova, Italy
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132, Genova, Italy.,Department of Health Sciences, University of Genoa, Genova, Italy
| | - Carola Torazza
- Department of Pharmacy, Section of Pharmacology and Toxicology and Center of Excellence for Biomedical Research, University of Genoa, Genova, Italy
| | - Silvia Bruno
- Department of Experimental Medicine, Human Anatomy, University of Genoa, Genova, Italy
| | | | - Silvia Ravera
- Department of Experimental Medicine, Human Anatomy, University of Genoa, Genova, Italy
| | - Marco Milanese
- Department of Pharmacy, Section of Pharmacology and Toxicology and Center of Excellence for Biomedical Research, University of Genoa, Genova, Italy
| | - Consuelo Venturi
- Department of Experimental Medicine, Human Anatomy, University of Genoa, Genova, Italy
| | | | | | - Laura Emionite
- Animal Facility, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132, Genova, Italy.,Department of Health Sciences, University of Genoa, Genova, Italy
| | - Anna Maria Orengo
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132, Genova, Italy
| | | | - Alberto Miceli
- Department of Health Sciences, University of Genoa, Genova, Italy
| | - Stefano Raffa
- Department of Health Sciences, University of Genoa, Genova, Italy
| | - Stefano Marra
- Department of Health Sciences, University of Genoa, Genova, Italy
| | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genova, Italy
| | - Katia Cortese
- Department of Experimental Medicine, Human Anatomy, University of Genoa, Genova, Italy
| | - Federica Grillo
- Department of Surgical Sciences and Integrated Diagnostics, Pathology Unit, University of Genoa, Genova, Italy
| | - Roberto Fiocca
- Department of Surgical Sciences and Integrated Diagnostics, Pathology Unit, University of Genoa, Genova, Italy
| | - Giambattista Bonanno
- Department of Pharmacy, Section of Pharmacology and Toxicology and Center of Excellence for Biomedical Research, University of Genoa, Genova, Italy.,Pharmacology and Toxicology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132, Genova, Italy.,Department of Health Sciences, University of Genoa, Genova, Italy
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25
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Miceli A, Raffa S, Donegani MI, Cossu V, Morbelli S, Marini C, Sambuceti G, Bauckneht M. Novel PET Tracers in the Management of Cardiac Sarcoidosis. Curr Radiopharm 2020; 14:220-227. [PMID: 32484775 DOI: 10.2174/1874471013666200602145418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/20/2020] [Accepted: 04/16/2020] [Indexed: 11/22/2022]
Abstract
Sarcoidosis is a systemic inflammatory disease of unknown etiology, pathologically characterized by non-caseating granulomas involving several organs and tissues. This pathological process can eventually affect the heart during his course leading to fibrosis associated with systolic dysfunction, conduction disturbance, and even sudden cardiac death. Due to this prognostic impact, diagnosis is crucial to optimize clinical management. The low sensitivity of endomyocardial biopsy and its invasive nature prevents its application as a first-line diagnostic approach. Thus, several efforts have been dedicated to the identification of advanced imaging tools for the diagnosis and monitoring of cardiac involvement in systemic sarcoidosis, including Positron Emission Tomography (PET). Starting from strengths and disadvantages of 18F-Fluorodeoxyglucose (18F-FDG) PET imaging, the present narrative review will summarize state of the art and future perspectives about radiotracers other than 18F-FDG of potential interest in the field of CS, including somatostatin receptor- ligands, proliferation markers and hypoxia displaying agents.
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Affiliation(s)
- Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | | | - Vanessa Cossu
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | - Cecilia Marini
- Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy
| | | | - Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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26
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Cossu V, Bauckneht M, Bruno S, Orengo AM, Emionite L, Balza E, Castellani P, Piccioli P, Miceli A, Raffa S, Borra A, Donegani MI, Carlone S, Morbelli S, Ravera S, Sambuceti G, Marini C. The Elusive Link Between Cancer FDG Uptake and Glycolytic Flux Explains the Preserved Diagnostic Accuracy of PET/CT in Diabetes. Transl Oncol 2020; 13:100752. [PMID: 32302773 PMCID: PMC7163080 DOI: 10.1016/j.tranon.2020.100752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/05/2020] [Accepted: 02/26/2020] [Indexed: 01/21/2023] Open
Abstract
This study aims to verify in experimental models of hyperglycemia induced by streptozotocin (STZ-DM) to what degree the high competition between unlabeled glucose and metformin (MET) treatment might affect the accuracy of cancer FDG imaging. The study included 36 “control” and 36 “STZ-DM” Balb/c mice, undergoing intraperitoneal injection of saline or streptozotocin, respectively. Two-weeks later, mice were subcutaneously implanted with breast (4 T1) or colon (CT26) cancer cells and subdivided in three subgroups for treatment with water or with MET at 10 or 750 mg/Kg/day. Two weeks after, mice were submitted to micro-PET imaging. Enzymatic pathways and response to oxidative stress were evaluated in harvested tumors. Finally, competition by glucose, 2-deoxyglucose (2DG) and the fluorescent analog 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino]-2-deoxyglucose (2-NBDG) on FDG uptake was studied in 4 T1 and CT26 cultured cells. STZ-DM slightly decreased cancer volume and FDG uptake rate (MRF). More importantly, it also abolished MET capability to decelerate lesion growth and MRF. This metabolic reprogramming closely agreed with the activity of hexose-6-phosphate dehydrogenase within the endoplasmic reticulum. Finally, co-incubation with 2DG virtually abolished FDG and 2-NBDG uptake within the endoplasmic reticulum in cultured cells. These data challenge the current dogma linking FDG uptake to glycolytic flux and introduce a new model to explain the relation between glucose analogue uptake and hexoses reticular metabolism. This selective fate of FDG contributes to the preserved sensitivity of PET imaging in oncology even in chronic moderate hyperglycemic conditions.
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Affiliation(s)
- Vanessa Cossu
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Health Sciences, University of Genoa, Italy
| | - Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Health Sciences, University of Genoa, Italy
| | - Silvia Bruno
- Department Experimental Medicine, University of Genoa, Italy
| | - Anna Maria Orengo
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Laura Emionite
- Animal Facility, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Enrica Balza
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Patrizia Piccioli
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alberto Miceli
- Department of Health Sciences, University of Genoa, Italy
| | - Stefano Raffa
- Department of Health Sciences, University of Genoa, Italy
| | - Anna Borra
- Department of Health Sciences, University of Genoa, Italy
| | | | | | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Silvia Ravera
- Department Experimental Medicine, University of Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Department of Health Sciences, University of Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genova, Italy; CNR Institute of Molecular Bioimaging and Physiology (IBFM), Milan, Italy.
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27
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Bauckneht M, Lai R, Miceli A, Schenone D, Cossu V, Donegani MI, Raffa S, Borra A, Marra S, Campi C, Orengo A, Massone AM, Tagliafico A, Caponnetto C, Cabona C, Cistaro A, Chiò A, Morbelli S, Nobili F, Sambuceti G, Piana M, Marini C. Spinal cord hypermetabolism extends to skeletal muscle in amyotrophic lateral sclerosis: a computational approach to [18F]-fluorodeoxyglucose PET/CT images. EJNMMI Res 2020; 10:23. [PMID: 32201914 PMCID: PMC7085992 DOI: 10.1186/s13550-020-0607-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/10/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease leading to neuromuscular palsy and death. We propose a computational approach to [18F]-fluorodeoxyglucose (FDG) PET/CT images to analyze the structure and metabolic pattern of skeletal muscle in ALS and its relationship with disease aggressiveness. MATERIALS AND METHODS A computational 3D method was used to extract whole psoas muscle's volumes and average attenuation coefficient (AAC) from CT images obtained by FDG PET/CT performed in 62 ALS patients and healthy controls. Psoas average standardized uptake value (normalized on the liver, N-SUV) and its distribution heterogeneity (defined as N-SUV variation coefficient, VC-SUV) were also extracted. Spinal cord and brain motor cortex FDG uptake were also estimated. RESULTS As previously described, FDG uptake was significantly higher in the spinal cord and lower in the brain motor cortex, in ALS compared to controls. While psoas AAC was similar in patients and controls, in ALS a significant reduction in psoas volume (3.6 ± 1.02 vs 4.12 ± 1.33 mL/kg; p < 0.01) and increase in psoas N-SUV (0.45 ± 0.19 vs 0.29 ± 0.09; p < 0.001) were observed. Higher heterogeneity of psoas FDG uptake was also documented in ALS (VC-SUV 8 ± 4%, vs 5 ± 2%, respectively, p < 0.001) and significantly predicted overall survival at Kaplan-Meier analysis. VC-SUV prognostic power was confirmed by univariate analysis, while the multivariate Cox regression model identified the spinal cord metabolic activation as the only independent prognostic biomarker. CONCLUSION The present data suggest the existence of a common mechanism contributing to disease progression through the metabolic impairment of both second motor neuron and its effector.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Rita Lai
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Daniela Schenone
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Vanessa Cossu
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Anna Borra
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Stefano Marra
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Cristina Campi
- Department of Medicine-DIMED, Padova University Hospital, Padua, Italy
| | - Annamaria Orengo
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Alberto Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Claudia Caponnetto
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Corrado Cabona
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Adriano Chiò
- ALS Center, Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.,AUO Città della Salute e della Scienza, Turin, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Flavio Nobili
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Michele Piana
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,CNR Institute of Molecular Bioimaging and Physiology (IBFM), Segrate (MI), Italy
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28
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Bauckneht M, Capitanio S, Donegani MI, Zanardi E, Miceli A, Murialdo R, Raffa S, Tomasello L, Vitti M, Cavo A, Catalano F, Mencoboni M, Ceppi M, Marini C, Fornarini G, Boccardo F, Sambuceti G, Morbelli S. Role of Baseline and Post-Therapy 18F-FDG PET in the Prognostic Stratification of Metastatic Castration-Resistant Prostate Cancer (mCRPC) Patients Treated with Radium-223. Cancers (Basel) 2019; 12:cancers12010031. [PMID: 31861942 PMCID: PMC7016706 DOI: 10.3390/cancers12010031] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 11/26/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 12/17/2022] Open
Abstract
Radium-223 dichloride (Ra223) represents the unique bone-directed treatment option that shows an improvement in overall survival (OS) in metastatic castrate resistant prostate cancer (mCRPC). However, there is an urgent need for the identification of reliable biomarkers to non-invasively determine its efficacy (possibly improving patients’ selection or identifying responders’ after therapy completion). 18F-Fluorodeoxyglucose (FDG)-avidity is low in naïve prostate cancer, but it is enhanced in advanced and chemotherapy-refractory mCRPC, providing prognostic insights. Moreover, this tool showed high potential for the evaluation of response in cancer patients with bone involvement. For these reasons, FDG Positron Emission Tomography (FDG-PET) might represent an effective tool that is able to provide prognostic stratification (improving patients selection) at baseline and assessing the treatment response to Ra223. We conducted a retrospective analysis of 28 mCRPC patients that were treated with Ra223 and submitted to bone scan and FDG-PET/CT for prognostic purposes at baseline and within two months after therapy completion. The following parameters were measured: number of bone lesions at bone scan, SUVmax of the hottest bone lesion, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). In patients who underwent post-therapy 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT), (20/28), PET Response Criteria in Solid Tumors (PERCIST), and European Organization for Research and Treatment of Cancer (EORTC) criteria were applied to evaluate the metabolic treatment response. The difference between end of therapy and baseline values was also calculated for Metabolic Tumor Volume (MTV), TLG, prostate-specific antigen (PSA), alkaline phosphatase (AP), and lactate dehydrogenase (LDH) (termed deltaMTV, deltaTLG, deltaPSA, deltaAP and deltaLDH, respectively). Predictive power of baseline and post-therapy PET- and biochemical-derived parameters on OS were assessed by Kaplan–Meier, univariate and multivariate analyses. At baseline, PSA, LDH, and MTV significantly predicted OS. However, MTV (but not PSA nor LDH) was able to identify a subgroup of patients with worse prognosis, even after adjusting for the number of lesions at bone scan (which, in turn, was not an independent predictor of OS). After therapy, PERCIST criteria were able to capture the response to Ra223 by demonstrating longer OS in patients with partial metabolic response. Moreover, the biochemical parameters were outperformed by PERCIST in the post-treatment setting, as their variation after therapy was not informative on long term OS. The present study supports the role of FDG-PET as a tool for patient’s selection and response assessment in mCRPC patients undergoing Ra223 administration.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
- Correspondence: ; Tel.: +39-0105553038; Fax: +39-0105556911
| | - Selene Capitanio
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
| | - Maria Isabella Donegani
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Elisa Zanardi
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.Z.); (L.T.); (F.B.)
- Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, 16132 Genoa, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Roberto Murialdo
- Internal Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy;
| | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Laura Tomasello
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.Z.); (L.T.); (F.B.)
| | - Martina Vitti
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Alessia Cavo
- Oncology Unit, Villa Scassi Hospital, 16149, Genova, Italy; (A.C.); (M.M.)
| | - Fabio Catalano
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (F.C.); (G.F.)
| | - Manlio Mencoboni
- Oncology Unit, Villa Scassi Hospital, 16149, Genova, Italy; (A.C.); (M.M.)
| | - Marcello Ceppi
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy;
| | - Cecilia Marini
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), 20090 Segrate (MI), Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (F.C.); (G.F.)
| | - Francesco Boccardo
- Academic Unit of Medical Oncology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (E.Z.); (L.T.); (F.B.)
- Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, 16132 Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (S.C.); (G.S.); (S.M.)
- Department of Health Sciences (DISSAL), University of Genova, 16132 Genoa, Italy; (M.I.D.); (A.M.); (S.R.); (M.V.); (C.M.)
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Bauckneht M, Cossu V, Castellani P, Piccioli P, Orengo AM, Emionite L, Di Giulio F, Donegani MI, Miceli A, Raffa S, Borra A, Capitanio S, Morbelli S, Caviglia G, Bruno S, Ravera S, Maggi D, Sambuceti G, Marini C. FDG uptake tracks the oxidative damage in diabetic skeletal muscle: An experimental study. Mol Metab 2019; 31:98-108. [PMID: 31918925 PMCID: PMC6920267 DOI: 10.1016/j.molmet.2019.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/29/2019] [Accepted: 11/03/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The present study aims to verify the relationship between glucose consumption and uptake of 18F-2-deoxy-glucose (FDG) in the skeletal muscle (SM) of experimental models of streptozotocin-induced diabetes mellitus (STZ-DM). METHODS The study included 36 Balb/c mice. Two weeks after intraperitoneal administration of saline (control group, n = 18) or 150 mg streptozotocin (STZ-DM group, n = 18), the two cohorts were submitted to an oral glucose tolerance test and were further subdivided into three groups (n = 6 each): untreated and treated with metformin (MTF) at low or high doses (10 or 750 mg/kg daily, respectively). Two weeks thereafter, all mice were submitted to dynamic micro-positron emission tomography (PET) imaging after prolonged fasting. After sacrifice, enzymatic pathways and response to oxidative stress were evaluated in harvested SM. RESULTS On PET imaging, the FDG uptake rate in hindlimb SM was significantly lower in nondiabetic mice as compared with STZ-DM-untreated mice. MTF had no significant effect on SM FDG uptake in untreated mice; however, its high dose induced a significant decrease in STZ-DM animals. Upon conventional analysis, the SM standard uptake value was higher in STZ-DM mice, while MTF was virtually ineffective in either control or STZ-DM models. This metabolic reprogramming was not explained by any change in cytosolic glucose metabolism. By contrast, it closely agreed with the catalytic function of hexose-6P-dehydrogenase (H6PD; i.e., the trigger of a specific pentose phosphate pathway selectively located within the endoplasmic reticulum). In agreement with this role, the H6PD enzymatic response to both STZ-DM and MTF matched the activation of the NADPH-dependent antioxidant responses to the increased generation of reactive oxygen species caused by chronic hyperglycemia. Ex vivo analysis of tracer kinetics confirmed that the enhanced SM avidity for FDG occurred despite a significant reduction in glucose consumption, while it was associated with increased radioactivity transfer to the endoplasmic reticulum. CONCLUSIONS These data challenge the current dogma linking FDG uptake to the glycolytic rate. They instead introduce a new model considering a strict link between the uptake of this glucose analog, H6PD reticular activity, and oxidative damage in diabetes, at least under fasting condition.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Vanessa Cossu
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Patrizia Castellani
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Patrizia Piccioli
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Anna Maria Orengo
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Laura Emionite
- Animal Facility, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Francesco Di Giulio
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | | | - Alberto Miceli
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Stefano Raffa
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Anna Borra
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Selene Capitanio
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Giacomo Caviglia
- Department Experimental Medicine, University of Genoa, Len Battista Alberti 2, 16132 Genoa, Italy
| | - Silvia Bruno
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
| | - Silvia Ravera
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
| | - Davide Maggi
- Diabetes Unit, IRCCS Ospedale Policlinico San Martino Genoa, Largo Benzi 10, 16132 Genoa, Italy; Department of Mathematics (DIMA), University of Genoa, Via Dodecaneso 35, 16146 Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; CNR Institute of Molecular Bioimaging and Physiology (IBFM), Via Fratelli Cervi 93, 20090 Segrate (MI), Italy.
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