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Minosse S, Picchi E, Ferrazzoli V, Pucci N, Da Ros V, Giocondo R, Floris R, Garaci F, Di Giuliano F. Influence of scan duration on dynamic contrast -enhanced magnetic resonance imaging pharmacokinetic parameters for brain lesions. Magn Reson Imaging 2024; 105:46-56. [PMID: 37939968 DOI: 10.1016/j.mri.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Gadolinium-based contrast agent needs time to leak into the extravascular-extracellular space, leak back into the vascular space, and reach an equilibrium state. For this reason, acquisition times of <10 min may cause inaccurate estimation of pharmacokinetic parameters. Since no studies have been conducted on the influence of long scan times on DCE-MRI parameters in brain tumors, the aim of this study is to investigate the variation of DCE-MRI-derived kinetic parameters as a function of acquisition time, from 5 to 10 min in brain tumors. MATERIALS AND METHODS Fifty-two patients with histologically confirmed brain tumors were enrolled in this retrospective study, and examination at 3 T, DCE-MRI, with scan duration of 10 min, was used for retrospective generation of 6 sets of quantitative DCE-MRI maps (Ktrans, Ve and Kep) from 5 to 10 min. Features were extracted from the DCE-MRI maps in contrast enhancement (CE) volumes. Kruskal-Wallis with post-hoc correction and coefficient of variation (CoV) were used as statistical test to compare DCE-MRI maps obtained from 6 data sets. SIGNIFICANCE p < 0.05. RESULTS No differences in Ktrans features in CE volumes between different scan durations. Ve, Kep features in CE volumes were influenced by different data length. The highest number of significantly different Ve and Kep features in CE volumes were between 5 min and 10 min (p < 0.013), 5 min and 9 min (p < 0.044), 6 min and 10 min (p < 0.040). CoV of Kep was reduced from 5 min to 10 min, going from highly variable (CoV = 0.70) to mildly variable (CoV = 0.42). CONCLUSION Kep and Ve were time-dependent in brain tumors, so a longer scan time is needed to obtain reliable parameter values. Ktrans was found to be time-independent, as it remains the same in all 6 acquisition times and is the only reliable parameter with short acquisition times.
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Affiliation(s)
- Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy.
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Valerio Da Ros
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Raffaella Giocondo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy; San Raffaele Cassino, Via Gaetano di Biasio 1, Cassino 03043, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy
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Minosse S, Picchi E, Conti A, di Giuliano F, di Ciò F, Sarmati L, Teti E, de Santis S, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Multishell diffusion MRI reveals whole-brain white matter changes in HIV. Hum Brain Mapp 2023; 44:5113-5124. [PMID: 37647214 PMCID: PMC10502617 DOI: 10.1002/hbm.26448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 07/15/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023] Open
Abstract
Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) have been previously used to explore white matter related to human immunodeficiency virus (HIV) infection. While DTI and DKI suffer from low specificity, the Combined Hindered and Restricted Model of Diffusion (CHARMED) provides additional microstructural specificity. We used these three models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. While significant group effects were found in all diffusion metrics, CHARMED and DKI analyses uncovered wider involvement (80% vs. 20%) of all white matter tracts in HIV infection compared with DTI. In restricted fraction (FR) analysis, we found significant differences in the left corticospinal tract, middle cerebellar peduncle, right inferior cerebellar peduncle, right corticospinal tract, splenium of the corpus callosum, left superior cerebellar peduncle, left superior cerebellar peduncle, pontine crossing tract, left posterior limb of the internal capsule, and left/right medial lemniscus. These are involved in language, motor, equilibrium, behavior, and proprioception, supporting the functional integration that is frequently impaired in HIV-positivity. Additionally, we employed a machine learning algorithm (XGBoost) to discriminate HIV-positive patients from healthy controls using DTI and CHARMED metrics on an ROIwise basis, and unique contributions to this discrimination were examined using Shapley Explanation values. The CHARMED and DKI estimates produced the best performance. Our results suggest that biophysical multishell imaging, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.
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Affiliation(s)
- Silvia Minosse
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
| | - Eliseo Picchi
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Allegra Conti
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesca di Giuliano
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Francesco di Ciò
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Loredana Sarmati
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Elisabetta Teti
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Silvia de Santis
- Instituto de NeurocienciasConsejo Superior de Investigaciones Científicas and Universidad Miguel HernándezSant Joan d'AlacantSpain
| | - Massimo Andreoni
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Roberto Floris
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Maria Guerrisi
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesco Garaci
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- IRCSS San Raffaele CassinoFrosinoneItaly
| | - Nicola Toschi
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Athinoula A. Martinos Center for Biomedical ImagingHarvard Medical SchoolBostonMassachusettsUSA
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Martucci A, Di Giuliano F, Minosse S, Pocobelli G, Nucci C, Garaci F. MRI and Clinical Biomarkers Overlap between Glaucoma and Alzheimer's Disease. Int J Mol Sci 2023; 24:14932. [PMID: 37834380 PMCID: PMC10573932 DOI: 10.3390/ijms241914932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Glaucoma is the leading cause of blindness worldwide. It is classically associated with structural and functional changes in the optic nerve head and retinal nerve fiber layer, but the damage is not limited to the eye. The involvement of the central visual pathways and disruption of brain network organization have been reported using advanced neuroimaging techniques. The brain structural changes at the level of the areas implied in processing visual information could justify the discrepancy between signs and symptoms and underlie the analogy of this disease with neurodegenerative dementias, such as Alzheimer's disease, and with the complex group of pathologies commonly referred to as "disconnection syndromes." This review aims to summarize the current state of the art on the use of advanced neuroimaging techniques in glaucoma and Alzheimer's disease, highlighting the emerging biomarkers shared by both diseases.
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Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; (S.M.); (F.G.)
| | - Giulio Pocobelli
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Francesco Garaci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; (S.M.); (F.G.)
- San Raffaele Cassino, 03043 Frosinone, Italy
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Picchi E, Leomanni P, Dell'Olio VB, Pucci N, Di Giuliano F, Ferrazzoli V, Minosse S, Rho M, Chiocchi M, Garaci F, Floris R. Triple gallbladder: radiological review. Clin J Gastroenterol 2023; 16:629-640. [PMID: 37563490 PMCID: PMC10539416 DOI: 10.1007/s12328-023-01829-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/01/2023] [Indexed: 08/12/2023]
Abstract
Triple gallbladder represents a rare congenital anatomical abnormality that can be a diagnostic challenge in reason to its rarity and consequential difficulties with diagnosis and identification. A systematic review of all published literature between 1958 and 2022 was performed. We identified 20 previous studies that provided 20 cases of triple gallbladder; our case was also included in the analysis, making a total of 21 patients. All patients underwent on diagnostic imaging examinations. After 1985, 9 patients underwent US examination which allowed prompt recognition of triple gallbladder in 2 patients only. CT was performed in 3 patients and allowed the correct diagnosis in a case. In 4 patients, was performed MRCP which allowed the correct diagnosis of triple gallbladder in all patients. Preoperative imaging allows the recognition of triple gallbladder in 9 of 21 patients (43%); in 12 patients (57%) the diagnosis was intraoperative. On patients considered, 16/21 underwent cholecystectomy. In 15 cases, the excised gallbladders were submitted for histopathological characterization with detection of metaplasia of the mucosa in 3 patients, while papillary adenocarcinoma was found in one. Imaging plays a key role in the identification of the anatomical variants of gallbladder, especially triple gallbladder, as modern imaging techniques allow a detailed assessment of the course of the biliary tract for a correct preoperative diagnosis. It is also crucial to be aware of the association between this condition and the metaplasia phenomena with the development of adenocarcinoma, as this may influence the patient's course of treatment.
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Affiliation(s)
- Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
| | - Paola Leomanni
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Vito Bruno Dell'Olio
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesca Di Giuliano
- Department of Biomedicine and Prevention, Neuroradiology Unit, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Ferrazzoli
- Department of Biomedicine and Prevention, Neuroradiology Unit, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Maurizio Rho
- Department of Surgical Science, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Marcello Chiocchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, Neuroradiology Unit, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
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Bovenzi R, Sancesario GM, Conti M, Grillo P, Cerroni R, Bissacco J, Forti P, Giannella E, Pieri M, Minosse S, Ferrazzoli V, Pucci N, Laudazi M, Floris R, Garaci F, Pierantozzi M, Stefani A, Mercuri NB, Picchi E, Di Giuliano F, Schirinzi T. Sex hormones differentially contribute to Parkinson's disease in males: a multimodal biomarker study. Eur J Neurol 2023. [PMID: 36971787 DOI: 10.1111/ene.15801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND AND PURPOSE Parkinson disease (PD) presents relevant sex-related differences in epidemiology, pathophysiology, and clinical features, with males being more vulnerable to the disease. Sex hormones might have a role, as the experimental models suggest; however, human-based evidence is scarce. Here, we integrated multimodal biomarkers to investigate the relationships between circulating sex hormones and clinical-pathological features in male PD patients. METHODS A cohort of 63 male PD patients underwent comprehensive clinical evaluation of motor and nonmotor disturbances; measurement of estradiol, testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) blood levels; and cerebrospinal fluid (CSF) assay of total α-synuclein, amyloid-β-42, amyloid-β-40, total tau, and phosphorylated-181 tau levels. A subgroup of 47 PD patients underwent brain volumetry by 3-T magnetic resonance imaging for further correlations. A control group of 56 age-matched individuals was enrolled for comparative analyses. RESULTS Male PD patients had higher estradiol and testosterone levels than controls. Estradiol had independent inverse associations with Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part 3 score and disease duration; it was also lower in nonfluctuating patients. Testosterone had inverse independent correlations with CSF α-synuclein and right globus pallidus volume. FSH and LH had age-dependent correlations with cognitive impairment and CSF amyloid-β-42/amyloid-β-40 ratio. CONCLUSIONS The study suggested that sex hormones could differentially contribute to clinical-pathological features of PD in male patients. Whereas estradiol might have a protective role in motor impairment, testosterone might be involved in male vulnerability to PD neuropathology. Gonadotropins instead might mediate age-dependent phenomena of amyloidopathy and cognitive decline.
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Affiliation(s)
- Roberta Bovenzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Matteo Conti
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Piergiorgio Grillo
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Rocco Cerroni
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Jacopo Bissacco
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Paolo Forti
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Emilia Giannella
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Clinical Biochemistry, Tor Vergata University Hospital, Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Mario Laudazi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- San Raffaele Cassino, Cassino, Italy
| | - Mariangela Pierantozzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandro Stefani
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Parkinson Centre Unit, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Da Ros V, Oddo L, Toumia Y, Guida E, Minosse S, Strigari L, Strolin S, Paolani G, Di Giuliano F, Floris R, Garaci F, Dolci S, Paradossi G, Domenici F. PVA-Microbubbles as a Radioembolization Platform: Formulation and the In Vitro Proof of Concept. Pharmaceutics 2023; 15:pharmaceutics15010217. [PMID: 36678846 PMCID: PMC9862136 DOI: 10.3390/pharmaceutics15010217] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
This proof-of-concept study lays the foundations for the development of a delivery strategy for radioactive lanthanides, such as Yttrium-90, against recurrent glioblastoma. Our appealing hypothesis is that by taking advantage of the combination of biocompatible polyvinyl alcohol (PVA) microbubbles (MBs) and endovascular radiopharmaceutical infusion, a minimally invasive selective radioembolization can be achieved, which can lead to personalized treatments limiting off-target toxicities for the normal brain. The results show the successful formulation strategy that turns the ultrasound contrast PVA-shelled microbubbles into a microdevice, exhibiting good loading efficiency of Yttrium cargo by complexation with a bifunctional chelator. The selective targeting of Yttrium-loaded MBs on the glioblastoma-associated tumor endothelial cells can be unlocked by the biorecognition between the overexpressed αVβ3 integrin and the ligand Cyclo(Arg-Gly-Asp-D-Phe-Lys) at the PVA microbubble surface. Hence, we show the suitability of PVA MBs as selective Y-microdevices for in situ injection via the smallest (i.e., 1.2F) neurointerventional microcatheter available on the market and the accumulation of PVA MBs on the HUVEC cell line model of integrin overexpression, thereby providing ~6 × 10-15 moles of Y90 per HUVEC cell. We further discuss the potential impact of using such versatile PVA MBs as a new therapeutic chance for treating glioblastoma multiforme recurrence.
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Affiliation(s)
- Valerio Da Ros
- Department of Biomedicine and Prevention, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Letizia Oddo
- Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Yosra Toumia
- Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Eugenia Guida
- Department of Biomedicine and Prevention, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Silvia Minosse
- UOC Diagnostica per Immagini, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Silvia Strolin
- Department of Medical Physics, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Giulia Paolani
- Department of Medical Physics, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy
| | - Francesca Di Giuliano
- Department of Biomedicine and Prevention, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Susanna Dolci
- Department of Biomedicine and Prevention, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Gaio Paradossi
- Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Fabio Domenici
- Department of Chemical Science and Technologies, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Correspondence:
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Di Giuliano F, Picchi E, Pucci N, Minosse S, Ferrazzoli V, Pizzicannella G, Angeloni C, Nasso D, Chiaravalloti A, Garaci F, Floris R. Comparison between diffusion-weighted magnetic resonance and positron-emission tomography in the evaluation of treated lymphomas with mediastinal involvement. Egypt J Radiol Nucl Med 2022. [DOI: 10.1186/s43055-022-00825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The persistence of residual tissue after treatment is frequent in patients with mediastinal lymphomas and it is often characterized by 18F-Flurodeoxyglucose Positron Emission Tomography (18F-FDG PET) uptake. This study aims to investigate the usefulness of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) sequence in residual tissues of treated mediastinal lymphomas and to compare it with 18F-FDG PET-CT.
Results
We included 21 patients with mediastinal Hodgkin and non-Hodgkin lymphomas who showed residual masses on PET-CT imaging at end of treatment and underwent DWIBS-Magnetic Resonance Imaging (MRI). SUVmax and Apparent Diffusion Coefficient (ADC) values of residual masses were assessed quantitatively, including measurement of mean ADC. 15 patients showed radiotracer uptake at 18F-FDG PET-CT, among them only 3 had positive DWIBS-MRI with low ADC values (median value: 0.90 mm2/s). The mediastinal biopsy in these 3 “double positive” patients confirmed pathological residual tissue. All the patients with positive 18F-FDG PET-CT but negative DWIBS-MRI (n = 18) with high ADC values (median value: 2.05 mm2/s) were confirmed negative by biopsy.
Conclusions
DWIBS-MRI examination combined with ADC measurement allowed to discriminate pathological and non-pathological residual tissue in patients with treated mediastinal lymphoma. These preliminary results seem to pave the way for a leading role of the MRI which could be a useful alternative to the 18F-FDG PET/CT.
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Favetta M, Romano A, Summa S, Colazza A, Minosse S, Vasco G, Castelli E, Petrarca M. Influence of sagittal pelvic attitude on gait pattern in normally developed people and interactions with neurological pathologies: A pilot study. Front Hum Neurosci 2022; 16:797282. [PMID: 35992946 PMCID: PMC9386486 DOI: 10.3389/fnhum.2022.797282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background Gait Analysis of healthy people, imitating pathological conditions while walking, has increased our understanding of biomechanical factors. The influence of the pelvis as a biomechanical constraint during gait is not specifically studied. How could mimicking a pelvic attitude influence the dynamic mechanical interaction of the body segments? We proposed an investigation of the pelvic attitude role on the gait pattern of typically developed people when they mimicked pelvic anteversion and posteroversion. Materials and methods Seventeen healthy volunteers were enrolled in this study (mean age 24.4 ± 5.5). They simulated a pelvic anteversion and posteroversion during walking, exaggerating these postures as much as possible. 3D gait analysis was conducted using an optoelectronic system with eight cameras (Vicon MX, Oxford, United Kingdom) and two force plates (AMTI, Or-6, Watertown, MA, United States). The kinematic, kinetic, and spatio-temporal parameters were compared between the three walking conditions (anteversion, posteroversion, and normal gait). Results In Pelvic Anteversion gait (PA) we found: increased hip flexion (p < 0.0001), increased knee flexion during stance (p = 0.02), and reduction of ankle flexion-extension Range of Motion (RoM) compared with Pelvic Normal gait (PN). In Pelvic Posteroversion gait (PP) compared with PN, we found: decreased hip flexion-extension RoM (p < 0.01) with a tendency to hip extension, decreased knee maximum extension in stance (p = 0.033), and increased ankle maximum dorsiflexion in stance (p = 0.002). Conclusion The configuration of PA contains gait similarities and differences when compared with pathologic gait where there is an anteversion as seen in children with Cerebral Palsy (CP) or Duchenne Muscular Dystrophy (DMD). Similarly, attitudes of PP have been described in patients with Charcot-Marie-Tooth Syndrome (CMT) or patients who have undergone Pelvic Osteotomy (PO). Understanding the dynamic biomechanical constraints is essential to the assessment of pathological behavior. The central nervous system adapts motor behavior in interaction with body constraints and available resources.
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Affiliation(s)
- Martina Favetta
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Alberto Romano
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Susanna Summa
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- *Correspondence: Susanna Summa,
| | - Alessandra Colazza
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Silvia Minosse
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Gessica Vasco
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Enrico Castelli
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Maurizio Petrarca
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
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Minosse S, Favetta M, Romano A, Pisano A, Summa S, Schirinzi T, Vasco G, Castelli E, Petrarca M. Comparison of the Gait Biomechanical Constraints in Three Different Type of Neuromotor Damages. Front Hum Neurosci 2022; 16:822205. [PMID: 35422690 PMCID: PMC9001917 DOI: 10.3389/fnhum.2022.822205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background and Objective Absolute angle represents the inclination of a body segment relative to a fixed reference in space. This work compares the absolute and relative angles for exploring biomechanical gait constraints. Methods Gait patterns of different neuromotor conditions were analyzed using 3D gait analysis: normal gait (healthy, H), Cerebral Palsy (CP), Charcot Marie Tooth (CMT) and Duchenne Muscular Dystrophy (DMD), representing central and peripheral nervous system and muscular disorders, respectively. Forty-two children underwent gait analysis: 10 children affected by CP, 10 children by CMT, 10 children by DMD and 12 healthy children. The kinematic and kinetic parameters were collected to describe the biomechanical pattern of participants’ lower limbs. The absolute angles of thigh, leg and foot were calculated using the trigonometric relationship of the tangent. For each absolute series, the mean, range, maximum, minimum and initial contact were calculated. Kinematic and kinetic gait data were studied, and the results were compared with the literature. Results Statistical analysis of the absolute angles showed how, at the local level, the single segments (thigh, leg and foot) behave differently depending on the pathology. However, if the lower limb is studied globally (sum of the kinematics of the three segments: thigh, leg and foot), a biomechanical constraint emerges. Conclusion Each segment compensates separately for the disease deficit so as to maintain a global biomechanical invariance. Using a model of inter-joint co-variation could improve the interpretation of the clinical gait pattern.
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Affiliation(s)
- Silvia Minosse
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Martina Favetta
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Alberto Romano
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Alessandra Pisano
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Susanna Summa
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- *Correspondence: Susanna Summa,
| | - Tommaso Schirinzi
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Gessica Vasco
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Enrico Castelli
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
| | - Maurizio Petrarca
- Department of Neurorehabilitation and Robotics, Movement Analysis and Robotics Laboratory (MARLab), “Bambino Gesù” Children’s Hospital, IRCCS, Rome, Italy
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10
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Minosse S, Picchi E, Giuliano FD, di Cio F, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Compartmental models for diffusion weighted MRI reveal widespread brain changes in HIV-infected patients. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:3834-3837. [PMID: 34892070 DOI: 10.1109/embc46164.2021.9629510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Diffusion tensor imaging (DTI) has been used to explore changes in the brain of subjects with human immunodeficiency virus (HIV) infection. However, DTI notoriously suffers from low specificity. Neurite orientation dispersion and density imaging (NODDI) is a compartmental model able to provide specific microstructural information with additional sensitivity/specificity. In this study we use both the NODDI and the DTI models to evaluate microstructural differences between 35 HIV-positive patients and 20 healthy controls. Diffusion-weighted imaging was acquired using three b-values (0, 1000 and 2500 s/mm2). Both DTI and NODDI models were fitted to the data, obtaining estimates for fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), neurite density index (NDI) and orientation dispersion index (ODI), after which we performed group comparisons using Tract-based spatial statistics (TBSS). While significant group effects were found in in FA, MD, RD, AD and NDI, NDI analysis uncovered a much wider involvement of brain tissue in HIV infection as compared to DTI. In region-of interest (ROI)-based analysis, NDI estimates from the right corticospinal tract produced excellent performance in discriminating the two groups (AUC = 0.974, sensitivity = 90%; specificity =97%).
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Di Cio F, Minosse S, Picchi E, Di Giuliano F, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Whole-brain white matter network reorganization in HIV. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:3830-3833. [PMID: 34892069 DOI: 10.1109/embc46164.2021.9629503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The human immunodeficiency virus (HIV) causes an infectious disease with a high viral tropism toward CD4 T-lymphocytes and macrophage. Since the advent of combined antiretroviral therapy (CART), the number of opportunistic infectious disease has diminished, turning HIV into a chronic condition. Nevertheless, HIV-infected patients suffer from several life-long symptoms, including the HIV-associated neurocognitive disorder (HAND), whose biological substrates remain unclear. HAND includes a range of cognitive impairments which have a huge impact on daily patient life. The aim of this study was to examine putative structural brain network changes in HIV-infected patient to test whether diffusion-imaging-related biomarkers could be used to discover and characterize subtle neurological alterations in HIV infection. To this end, we employed multi-shell, multi-tissue constrained spherical deconvolution in conjunction with probabilistic tractography and graph-theoretical analyses. We found several statistically significant effects in both local (right postcentral gyrus, right precuneus, right inferior parietal lobule, right transverse temporal gyrus, right inferior temporal gyrus, right putamen and right pallidum) and global graph-theoretical measures (global clustering coefficient, global efficiency and transitivity). Our study highlights a global and local reorganization of the structural connectome which support the possible application of graph theory to detect subtle alteration of brain regions in HIV patients.Clinical Relevance-Brain measures able to detect subtle alteration in HIV patients could also be used in e.g. evaluating therapeutic responses, hence empowering clinical trials.
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Minosse S, Garaci F, Martino F, Di Mauro R, Melis M, Di Giuliano F, Picchi E, Guerrisi M, Floris R, Di Girolamo S, Toschi N. Global and local brain connectivity changes associated with sudden unilateral sensorineural hearing loss. NMR Biomed 2021; 34:e4544. [PMID: 34046962 DOI: 10.1002/nbm.4544] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
Recent studies suggest that even moderate sudden sensorineural hearing loss (SSNHL) causes reduction of gray matter volume in the primary auditory cortex, diminishing its ability to react to sound stimulation, as well as reorganization of functional brain networks. We employed resting-state functional MRI (rs-fMRI), in conjunction with graph-theoretical analysis and a newly developed functional "disruption index," to study whole-brain as well as local functional changes in patients with unilateral SSNHL. We also assessed the potential of graph-theoretical measures as biomarkers of disease, in terms of their relationship to clinically relevant audiological parameters. Eight patients with moderate or severe unilateral SSNHL and 15 healthy controls were included in this prospective pilot study. All patients underwent rs-fMRI to study potential changes in brain connectivity. From rs-fMRI data, global and local graph-theoretical measures, disruption index, and audiological examinations were estimated. Mann-Whitney U tests were used to study the differences between SSNHL patients and healthy controls. Associations between brain metrics and clinical variables were studied using multiple linear regressions, and the presence or absence of brain network hubs was assessed using Fisher's exact test. No statistically significant differences between SSNHL patients and healthy controls were found in global or local network measures. However, when analyzing brain networks through the disruption index, we found a brain-wide functional network reorganization (p < 0.001 as compared with controls), whose extent was associated with clinical impairment (p < 0.05). We also observed several functional hubs in SSNHL patients that were not present in healthy controls and vice versa. Our results demonstrate a brain involvement in SSNHL patients, not detectable using conventional graph-theoretical analysis, which may yield subtle disease clues and possibly aid in monitoring disease progression in clinical trials.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
- San Raffaele Cassino, Cassino, Frosinone, Italy
| | - Federica Martino
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Roberta Di Mauro
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
- Neuroscience Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Milena Melis
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Stefano Di Girolamo
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts
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Di Giuliano F, Minosse S, Picchi E, Ferrazzoli V, Da Ros V, Muto M, Pistolese CA, Garaci F, Floris R. Qualitative and quantitative analysis of 3D T1 Silent imaging. Radiol Med 2021; 126:1207-1215. [PMID: 34131844 DOI: 10.1007/s11547-021-01380-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/20/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To compare brain magnetic resonance imaging (MRI) using T1 3D Silent and fast T1 3D Gradient-Echo (GRE) BRAin VOlume (known as BRAVO) sequences. The primary aim is to assess the quantitative and qualitative analysis of Silent and BRAVO images by the measurement of the contrast (C), the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). The second aim is to estimate the subjective sound levels and the specific absorption rate (SAR). METHODS Twenty-two subjects had T1 3D Silent and T1 3D BRAVO sequences added to the standard MR examination. The qualitative analysis of the two sequences was performed by two radiologists independently. The quantitative analysis was performed by placing regions of interest on the cerebrospinal fluid, on the white and grey matter. The C, the CNR and the SNR were calculated for each sequence. After each T1-3D sequence, subjects gave a score rating to evaluate the acoustic noise. Finally, the SAR was evaluated by the digital imaging and communications in medicine (DICOM) tags. RESULTS The image quality scores obtained by the two radiologists were higher for BRAVO compared to the Silent. However, qualitatively, the Silent images were similar to BRAVO for diagnostic use. Quantitatively, CNR for GM-CSF was comparable in the two sequences and SNR in CSF was higher in Silent than BRAVO. The acoustic noise of Silent sequence was statistically lower compared with BRAVO. The maximum SAR measured was 1.4 W/kg. CONCLUSIONS 3D T1 Silent can be a valid alternative technique to conventional BRAVO to reduce the acoustic noise preserving the diagnostic accuracy. However, radiologists preferred the conventional sequence to Silent.
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Affiliation(s)
- Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy.
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Valerio Da Ros
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Massimo Muto
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80100, Naples, Italy
| | - Chiara Adriana Pistolese
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- San Raffaele Cassino, Cassino, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
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14
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Minosse S, Picchi E, Di Giuliano F, Sarmati L, Teti E, Pistolese CA, Lanzafame S, Di Ciò F, Guerrisi M, Andreoni M, Floris R, Toschi N, Garaci F. Functional brain network reorganization in HIV infection. J Neuroimaging 2021; 31:796-808. [PMID: 33900655 DOI: 10.1111/jon.12861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND PURPOSE To investigate the reorganization of the central nervous system provided by resting state-functional MRI (rs-fMRI), graph-theoretical analysis, and a newly developed functional brain network disruption index in patients with human immunodeficiency virus (HIV) infection. METHODS Forty HIV-positive patients without neurological impairment and 20 age- and sex-matched healthy controls underwent rs-fMRI at 3T; blood sampling was obtained the same day to evaluate biochemical variables (absolute, relative, and nadir CD4 T-lymphocytes value and plasmatic HIV-RNA). From fMRI data, disruption indices, as well as global and local graph theoretical measures, were estimated and examined for group differences (HIV vs. controls) as well as for associations with biochemical variables (HIV only). Finally, all data (global and local graph-theoretical measures, disruption indices, and biochemical variables) were tested for putative differences across three patient groups based on the duration of combined antiretroviral therapy (cART). RESULTS Brain function of HIV patients appeared to be deeply reorganized as compared to normal controls. The disruption index showed significant negative association with relative CD4 values, and a positive significant association between plasmatic HIV-RNA and local graph-theoretical metrics in the left lingual gyrus and the right lobule IV and V of right cerebellar hemisphere was also observed. Finally, a differential distribution of HIV clinical biomarkers and several brain metrics was observed across cART duration groups. CONCLUSION Our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early and subtle functional changes of brain networks in HIV patients.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,San Raffaele Cassino, Frosinone, Italy
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Petrarca M, Frascarelli F, Carniel S, Colazza A, Minosse S, Tavernese E, Castelli E. Robotic-assisted locomotor treadmill therapy does not change gait pattern in children with cerebral palsy. Int J Rehabil Res 2021; 44:69-76. [PMID: 33290305 DOI: 10.1097/mrr.0000000000000451] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although robotic-assisted locomotor treadmill therapy is utilized on children with cerebral palsy (CP), its impact on the gait pattern in childhood is not fully described. We investigated the outcome of robotized gait training focusing on the gait pattern modifications and mobility in individuals with CP. An additional intention is to compare our results with the previous literature advancing future solutions. Twenty-four children with diplegic CP (average age 6.4 years old with Gross Motor Functional Classification System range I-IV) received robotized gait training five times per week for 4 weeks. Gait analysis and Gross Motor Function Measurement (GMFM) assessments were performed before and at the end of the treatment. Gait analysis showed inconsistent modifications of the gait pattern. GMFM showed a mild improvement of the dimension D in all subjects, while dimension E changed only in the younger and more severely affected patients. In this study, a detailed investigation comprehensive of electromyography patterns, where previous literature reported only sparse data without giving information on the whole gait pattern, were conducted. We carried on the analysis considering the age of the participants and the severity of the gait function. The findings differentiate the concept of specific pattern recovery (no gait pattern changes) from the concept of physical training (mild GMFM changes).
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Affiliation(s)
- Maurizio Petrarca
- Paediatric Neurorehabilitation Division, 'Bambino Gesù' Children's Hospital - IRCCS, Rome, Italy
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Nucci C, Garaci F, Altobelli S, Di Ciò F, Martucci A, Aiello F, Lanzafame S, Di Giuliano F, Picchi E, Minosse S, Cesareo M, Guerrisi MG, Floris R, Passamonti L, Toschi N. Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma. J Clin Med 2020; 9:jcm9103122. [PMID: 32992559 PMCID: PMC7600134 DOI: 10.3390/jcm9103122] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells and loss of their axons, progressively leading to blindness. Recently, glaucoma has been conceptualized as a more diffuse neurodegenerative disorder involving the optic nerve and also the entire brain. Consistently, previous studies have used a variety of magnetic resonance imaging (MRI) techniques and described widespread changes in the grey and white matter of patients. Diffusion kurtosis imaging (DKI) provides additional information as compared with diffusion tensor imaging (DTI), and consistently provides higher sensitivity to early microstructural white matter modification. In this study, we employ DKI to evaluate differences among healthy controls and a mixed population of primary open angle glaucoma patients ranging from stage I to V according to Hodapp–Parrish–Anderson visual field impairment classification. To this end, a cohort of patients affected by primary open angle glaucoma (n = 23) and a group of healthy volunteers (n = 15) were prospectively enrolled and underwent an ophthalmological evaluation followed by magnetic resonance imaging (MRI) using a 3T MR scanner. After estimating both DTI indices, whole-brain, voxel-wise statistical comparisons were performed in white matter using Tract-Based Spatial Statistics (TBSS). We found widespread differences in several white matter tracts in patients with glaucoma relative to controls in several metrics (mean kurtosis, kurtosis anisotropy, radial kurtosis, and fractional anisotropy) which involved localization well beyond the visual pathways, and involved cognitive, motor, face recognition, and orientation functions amongst others. Our findings lend further support to a causal brain involvement in glaucoma and offer alternative explanations for a number of multidomain impairments often observed in glaucoma patients.
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Affiliation(s)
- Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
- San Raffaele Cassino, 03043 Frosinone, Italy
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Simone Altobelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Maria Giovanna Guerrisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, 20090 Milano, Italy
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, 149 13th Street, Boston, MA 02129, USA
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Di Ciò F, Garaci F, Minosse S, Passamonti L, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Guerrisi MG, Floris R, Nucci C, Toschi N. Reorganization of the structural connectome in primary open angle Glaucoma. Neuroimage Clin 2020; 28:102419. [PMID: 33032067 PMCID: PMC7552094 DOI: 10.1016/j.nicl.2020.102419] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 12/18/2022]
Abstract
Primary open angle Glaucoma (POAG) is one of the most common causes of permanent blindness in the world. Recent studies have suggested the hypothesis that POAG is also a central nervous system disorder which may result in additional (i.e., extra-ocular) involvement. The aim of this study is to assess possible structural, whole-brain connectivity alterations in POAG patients. We evaluated 23 POAG patients and 15 healthy controls by combining multi-shell diffusion weighted imaging, multi-shell, multi-tissue probabilistic tractography, graph theoretical measures and a recently designed 'disruption index', which evaluates the global reorganization of brain networks. We also studied the associations between the whole-brain structural connectivity measures and indices of visual acuity including the field index (VFI) and two Optical Coherence Tomography (OCT) parameters, namely the Macula Ganglion Cell Layer (MaculaGCL) and Retinal Nerve Fiber Layer (RNFL) thicknesses. We found both global and local structural connectivity differences between POAG patients and controls, which extended well beyond the primary visual pathway and were localized in the left calcarine gyrus (clustering coefficient p = 0.036), left lateral occipital cortex (clustering coefficient p = 0.017, local efficiency p = 0.035), right lingual gyrus (clustering coefficient p = 0.009), and right paracentral lobule (clustering coefficient p = 0.009, local efficiency p = 0.018). Group-wise (clustering coefficient, p = 6.59∙10-7 and local efficiency p = 6.23·10-8) and subject-wise disruption indices (clustering coefficient, p = 0.018 and local efficiency, p = 0.01) also differed between POAG patients and controls. In addition, we found negative associations between RNFL thickness and local measures (clustering coefficient, local efficiency and strength) in the right amygdala (local efficiency p = 0.008, local strength p = 0.016), right inferior temporal gyrus (clustering coefficient p = 0.036, local efficiency p = 0.042), and right temporal pole (local strength p = 0.008). Overall, we show, in patients with POAG, a whole-brain structural reorganization that spans across a variety of brain regions involved in visual processing, motor control, and emotional/cognitive functions. We also identified a pattern of brain structural changes in relation to POAG clinical severity. Taken together, our findings support the hypothesis that the reduction in visual acuity from POAG can be driven by a combination of local (i.e., in the eye) and more extended (i.e., brain) effects.
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Affiliation(s)
- Francesco Di Ciò
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy.
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; San Raffaele Cassino, Frosinone, Italy
| | - Silvia Minosse
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milano, Italy; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Giovanna Guerrisi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy; Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA.
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Cio FD, Garaci F, Minosse S, Passamonti L, Martucci A, Lanzafame S, Giuliano FD, Picchi E, Mancino R, Guerrisi M, Nucci C, Floris R, Toschi N. Disruption of structural brain networks in Primary Open Angle Glaucoma. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1705-1708. [PMID: 33018325 DOI: 10.1109/embc44109.2020.9175417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Primary open angle glaucoma (POAG) is one of the most common causes of permanent blindness in the world. Recent studies have originated the hypothesis that POAG could be considered as a central nervous system pathology which results in secondary visual involvement. The aim of this study is to assess possible structural whole brain connectivity alterations in POAG by combining multi-shell diffusion weighted imaging, multi-shell multi-tissue probabilistic tractography, graph theoretical measures and a newly designed disruption index, which evaluates the global reorganization of brain networks in group-wise comparisons. We found global differences in structural connectivity between Glaucoma patients and controls, as well as in local graph theoretical measures. These changes extended well beyond the primary visual pathway. Furthermore, group-wise and subject-wise disruption indices were found to be statistically different between glaucoma patients and controls, with a positive slope. Overall, our results support the hypothesis of a whole-brain structural reorganization in glaucoma which is specific to structural connectivity, possibly placing this disease within the recently defined groups of brain disconnection syndrome.
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Minosse S, Picchi E, Giuliano FD, Lanzafame S, Manenti G, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Disruption of brain network organization in patients with human immunodeficiency virus (HIV) infection. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1726-1729. [PMID: 33018330 DOI: 10.1109/embc44109.2020.9176449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In 2019, approximately 38 million people were living with human immunodeficiency virus (HIV). Combined antiretroviral therapy (cART) has determined a change in the course of HIV infection, transforming it into a chronic condition which results in cumulative exposure to antiretroviral drugs, inflammatory effects and aging. Relatedly, at least one quarter of HIV-infected patients suffer from cognitive, motor and behavioral disorder, globally known as HIV-associated neurocognitive disorders (HAND). In this context, objective, neuroimaging-based biomarkers are therefore highly desirable in order to detect, quantify and monitor HAND in all disease stages. In this study, we employed functional MRI in conjunction with graph-theoretical analysis as well as a newly developed functional brain network disruption index to assess a putative functional reorganization in HIV positive patients. We found that brain function of HIV patients is deeply reorganized as compared to normal controls. Interestingly, the regions in which we found reorganized hubs are integrated into neuronal networks involved in working memory, motor and executive functions often altered in patients with HAND. Overall, our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early, subtle functional changes of brain networks in HIV patients before structural changes become evident.
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Minosse S, Garaci F, Martino F, Mauro RD, Melis M, Giuliano FD, Picchi E, Floris R, Guerrisi M, Girolamo SD, Toschi N. Global and local reorganization of brain network connectivity in sudden sensorineural hearing loss. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1730-1733. [PMID: 33018331 DOI: 10.1109/embc44109.2020.9175688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recent reports suggested that even moderate sudden sensorineural hearing loss (SSNHL) can be partly responsible for a loss of gray matter volume in the primary auditory cortex, hence reducing the capacity of the auditory cortical areas to react to sound stimulation. There is also evidence for a plastic reorganization of brain functional networks visible as enhanced local functional connectivity. The aim of this study was to use rs-fMRI, in conjunction with graph- theoretical analysis and a newly developed functional "disruption index" to study whole-brain as well as local functional changes in patients with acute and unilateral sensorineural hearing loss. No statistically significant differences in global or local network measures we found between SSNHL patients and healthy controls. However, when analyzing local metrics through the disruption index k, we found negative values for k which were statistically different from zero both in single subject analysis. Additionally, we found several associations between graph-theoretical metrics and clinical parameters.
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Summa S, Schirinzi T, Favetta M, Romano A, Minosse S, Diodato D, Olivieri G, Martinelli D, Sancesario A, Zanni G, Castelli E, Bertini E, Petrarca M, Vasco G. A wearable video-oculography based evaluation of saccades and respective clinical correlates in patients with early onset ataxia. J Neurosci Methods 2020; 338:108697. [DOI: 10.1016/j.jneumeth.2020.108697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
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Di Giuliano F, Picchi E, Muto M, Calcagni A, Ferrazzoli V, Da Ros V, Minosse S, Chiaravalloti A, Garaci F, Floris R, Muto M. Radiological imaging in multiple myeloma: review of the state-of-the-art. Neuroradiology 2020; 62:905-923. [DOI: 10.1007/s00234-020-02417-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 03/26/2020] [Indexed: 12/16/2022]
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Minosse S, Marzi S, Piludu F, Boellis A, Terrenato I, Pellini R, Covello R, Vidiri A. Diffusion kurtosis imaging in head and neck cancer: A correlation study with dynamic contrast enhanced MRI. Phys Med 2020; 73:22-28. [PMID: 32279047 DOI: 10.1016/j.ejmp.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/11/2020] [Accepted: 04/02/2020] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To investigate the biophysical meaning of Diffusion Kurtosis Imaging (DKI) parameters via correlations with the perfusion parameters obtained from a long Dynamic Contrast Enhanced MRI scan, in head and neck (HN) cancer. METHODS Twenty two patients with newly diagnosed HN tumor were included in the present retrospective study. Some patients had multiple lesions, therefore a total of 26 lesions were analyzed. DKI was acquired using 5b values at 0, 500, 1000,1500 and 2000 s/mm2. DCE-MRI was obtained with 130 dynamic volumes, with a temporal resolution of 5 s, to achieve a long scan time (>10 min). The apparent diffusion coefficient Dapp and apparent diffusional kurtosis Kapp were calculated voxel-by-voxel, removing the point at b value = 0 to eliminate possible perfusion effects on the parameter estimations. The transfer constants Ktrans and Kep, ve, and the histogram-based entropy (En) and interquartile range (IQR) of each DCE-MRI parameter were quantified. Correlations between all variables were investigated by the Spearman's Rho correlation test. RESULTS Moderate relationships emerged between Dapp and Kep (Rho = - 0.510, p = 0.009), and between Dapp and ve (Rho = 0.418, p = 0.038). En(Kep) was significantly related to Kapp (Rho = 0.407, p = 0.043), while IQR(Kep) showed an inverse association with Dapp (Rho = -0.422, p = 0.035). CONCLUSIONS A weak to intermediate correlation was found between DKI parameters and both Kep and ve. The kurtosis was associated to the intratumoral heterogeneity and complexity of the capillary permeability, expressed by En(Kep).
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Affiliation(s)
- Silvia Minosse
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Simona Marzi
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Francesca Piludu
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Alessandro Boellis
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy; Department of Radiology, S. Andrea Hospital, Via Vittorio Veneto 197, 19124 La Spezia, Italy
| | - Irene Terrenato
- Biostatistics-Scientific Direction, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Raul Pellini
- Department of Otolaryngology & Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Antonello Vidiri
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
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Schirinzi T, Favetta M, Romano A, Sancesario A, Summa S, Minosse S, Zanni G, Castelli E, Bertini E, Petrarca M, Vasco G. One-year outcome of coenzyme Q10 supplementation in ADCK3 ataxia (ARCA2). Cerebellum Ataxias 2019; 6:15. [PMID: 31890231 PMCID: PMC6916514 DOI: 10.1186/s40673-019-0109-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 11/10/2022]
Abstract
Background The recessive ataxia ARCA2 is a rare disorder characterized by Coenzyme Q10 (CoQ10) deficiency due to biallelic mutations in ADCK3 gene. Despite the pathophysiological role, available data are not univocal on clinical efficacy of CoQ10 supplementation in ARCA2. Here we described the long-term motor outcome of 4 untreated ARCA2 patients prospectively followed-up for one year after starting CoQ10 oral supplementation (15 mg/kg/day). Methods Clinical rating scales (SARA; 9 holes peg test; 6 min walking test; Timed 25-Foot Walk) and videoelectronic gait analysis were performed at baseline and every 6 months (T0, T1, T2) to evaluate the motor performances. Since two patients discontinued the treatment at the 7th month, we could provide comparative analysis between longer and shorter supplementation. Results At T2, the gait speed (Timed 25-Foot Walk test) significantly differed between patients with long and short treatment; overall, the clinical condition tended to be better in patients continuing CoQ10. Conclusions Although preliminarily, this observation suggests that only prolonged and continuous CoQ10 supplementation may induce mild clinical effects on general motor features of ARCA2. Dedicated trials are now necessary to extend and validate such observation.
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Affiliation(s)
- Tommaso Schirinzi
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy.,2Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Martina Favetta
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Alberto Romano
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Andrea Sancesario
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy.,2Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Susanna Summa
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Silvia Minosse
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Ginevra Zanni
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Enrico Castelli
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Enrico Bertini
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Maurizio Petrarca
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
| | - Gessica Vasco
- 1Department of Neurosciences, Bambino Gesù Hospital, via della Torre di Palidoro, Fiumicino, Rome, Italy
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Romano A, Favetta M, Schirinzi T, Summa S, Minosse S, D'Amico A, Catteruccia M, Petrarca M, Castelli E, Bertini E, Vasco G. Evaluation of gait in Duchenne Muscular Dystrophy: Relation of 3D gait analysis to clinical assessment. Neuromuscul Disord 2019; 29:920-929. [PMID: 31791868 DOI: 10.1016/j.nmd.2019.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/26/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
Walking ability in Duchenne Muscular Dystrophy (DMD) deteriorates progressively until complete loss of the function. Interventions aimed at maintaining ambulatory ability relies on accurate clinical-based scores and evaluations of walking. This kind of assessment has intrinsic limitations. A 3D optoelectronic system could provide elements useful for the functional evaluation of patients with DMD. Nineteen boys with DMD were evaluated using the 6-Minutes Walking Test, North Star Ambulatory Assessment and 3D gait analysis. Participants' gait parameters were compared to those of an age-matched control group and correlated with standard clinical scores. Seventeen kinematic variables differed between DMD and control groups. Strong correlations with North Star Ambulatory Assessment were found for stride width, gait velocity and ankle angles on the sagittal plane. The 6-Minutes Walking test did not correlate with investigated kinematic variables but showed a correlation with North Star Ambulatory Assessment. Our data support the reported DMD gait pattern characterized by increased anterior pelvic tilt and ankle plantar flexion. The stride width and ankle kinematics emerged as the main representative gait parameters of DMD global ambulatory status. Although preliminary, our findings suggest that 3D gait analysis may provide useful objective and accurate parameters reflecting the functional ability of individuals with DMD.
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Affiliation(s)
- Alberto Romano
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Martina Favetta
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Tommaso Schirinzi
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy; Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Susanna Summa
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Silvia Minosse
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Adele D'Amico
- Department of Neuroscience, Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children's Hospital, Rome, Italy
| | - Michela Catteruccia
- Department of Neuroscience, Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children's Hospital, Rome, Italy
| | - Maurizio Petrarca
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy.
| | - Enrico Castelli
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
| | - Enrico Bertini
- Department of Neuroscience, Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children's Hospital, Rome, Italy
| | - Gessica Vasco
- Department of Neuroscience, Unit of Neurorehabilitation, Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Via della torre di Palidoro, snc, Fiumicino, Rome, Italy
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Di Giuliano F, Minosse S, Picchi E, Marfia GA, Da Ros V, Muto M, Muto M, Pistolese CA, Laghi A, Garaci F, Floris R. Comparison between synthetic and conventional magnetic resonance imaging in patients with multiple sclerosis and controls. MAGMA 2019; 33:549-557. [PMID: 31782035 DOI: 10.1007/s10334-019-00804-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 10/30/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Synthetic magnetic resonance imaging (SyMRI) allows to obtain different weighted-images using the multiple-dynamic multiple-echo sequence lasting 6 min. The aim is to compare quantitatively and qualitatively synthetic- and conventional MRI in patients with multiple sclerosis (MS) and controls assessing the contrast (C), the signal to noise ratio (SNR), and the contrast to noise ratio (CNR). We evaluated the lesion count and lesion-to-white matter contrast ([Formula: see text] in the MS patients. METHODS AND METHODS 51 patients underwent synthetic- and conventional MRI. Qualitative analysis was evaluated by assigning scores to all synthetic- and conventional MRI sequences by two neuroradiologists. Lesions were counted in MS patients both in the conventional- and synthetic T2-FLAIR. Regions of interest were placed in the cerebrospinal fluid, in the white- and grey matter. For the sequences were evaluated: C, CNR, and SNR. RESULTS Synthetic T2-FLAIR images are qualitatively inferior. C and CNR were significantly higher in synthetic T1W and T2W images compared to conventional images, but not for T2-FLAIR. The SNR value was always lower in synthetic images than in conventional ones. CONCLUSIONS SyMRI can be used in clinical practice because it has a similar diagnostic accuracy which reduces the scanning time compared to the conventional one. However, synthetic T2-FLAIR images need to be improved.
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Affiliation(s)
- Francesca Di Giuliano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Girolama Alessandra Marfia
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Neurology Unit, Department of Neurosciences, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Valerio Da Ros
- Department of Diagnostic Imaging and Interventional Radiology, Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Massimo Muto
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80100, Naples, Italy
| | - Mario Muto
- Department of Neuroradiology, A.O.R.N. Cardarelli, 80100, Naples, Italy
| | - Chiara Adriana Pistolese
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Andrea Laghi
- Department of Surgical and Medical Sciences and Translational Medicine, Radiology Unit, "Sapienza" University of Rome, Sant'Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,U.O.C Diagnostic Imaging and Neuroradiology, Department of Integrated Care Processes, Fondazione PTV Policlinico "Tor Vergata", University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
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Minosse S, Garaci F, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Mancino R, Guerrisi M, Pistolese CA, Floris R, Nucci C, Toschi N. Primary Open Angle Glaucoma Is Associated With Functional Brain Network Reorganization. Front Neurol 2019; 10:1134. [PMID: 31708862 PMCID: PMC6823877 DOI: 10.3389/fneur.2019.01134] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/10/2019] [Indexed: 01/21/2023] Open
Abstract
Background: Resting-state functional magnetic resonance imaging (rs-fMRI) is commonly employed to study changes in functional brain connectivity. The recent hypothesis of a brain involvement in primary open angle Glaucoma has sprung interest for neuroimaging studies in this classically ophthalmological pathology. Object: We explored a putative reorganization of functional brain networks in Glaucomatous patients, and evaluated the potential of functional network disruption indices as biomarkers of disease severity in terms of their relationship to clinical variables as well as select retinal layer thicknesses. Methods: Nineteen Glaucoma patients and 16 healthy control subjects (age: 50–76, mean 61.0 ± 8.2 years) underwent rs-fMRI examination at 3T. After preprocessing, rs-fMRI time series were parcellated into 116 regions using the Automated Anatomical Labeling atlas and adjacency matrices were computed based on partial correlations. Graph-theoretical measures of integration, segregation and centrality as well as group-wise and subject-wise disruption index estimates (which use regression of graph-theoretical metrics across subjects to quantify overall network changes) were then generated for all subjects. All subjects also underwent Optical Coherence Tomography (OCT) and visual field index (VFI) quantification. We then examined associations between brain network measures and VFI, as well as thickness of retinal nerve fiber layer (RNFL) and macular ganglion cell layer (MaculaGCL). Results: In Glaucoma, group-wise disruption indices were negative for all graph theoretical metrics. Also, we found statistically significant group-wise differences in subject-wise disruption indexes in all local metrics. Two brain regions serving as hubs in healthy controls were not present in the Glaucoma group. Instead, three hub regions were present in Glaucoma patients but not in controls. We found significant associations between all disruption indices and VFI, RNFL as well as MaculaGCL. The disruption index based on the clustering coefficient yielded the best discriminative power for differentiating Glaucoma patients from healthy controls [Area Under the ROC curve (AUC) 0.91, sensitivity, 100%; specificity, 78.95%]. Conclusions: Our findings support a possible relationship between functional brain changes and disease severity in Glaucoma, as well as alternative explanations for motor and cognitive symptoms in Glaucoma, possibly pointing toward an inclusion of this pathology in the heterogeneous group of disconnection syndromes.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,San Raffaele Cassino, Cassino, Italy
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Raffaele Mancino
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, United States
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Garaci F, Picchi E, Di Giuliano F, Lanzafame S, Minosse S, Manenti G, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Toschi N. Cerebral Multishell Diffusion Imaging Parameters are Associated with Blood Biomarkers of Disease Severity in HIV Infection. J Neuroimaging 2019; 29:771-778. [PMID: 31304996 DOI: 10.1111/jon.12655] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/23/2019] [Accepted: 06/26/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE HIV-positive subjects suffer from neurocognitive deficits and disorder. We employ multishell diffusion imaging to investigate possible white matter microstructural correlates of infection severity, quantified through plasmatic percentage value of CD4 T-lymphocytes, Nadir-CD4 count, and plasma concentration of human immunodeficiency virus (HIV)-ribonucleic acid (RNA). METHODS A total of 41 HIV patients underwent magnetic resonance imaging (MRI) and blood sampling to evaluate biochemical markers. Diffusion-weighted imaging was performed at 3 Tesla (b-values: 1000 s/mm² and 2500 s/mm², 64 gradient directions/b-value, 8 b0 images). The Diffusion Tensor Imaging and Diffusional Kurtosis Imaging models were fitted separately after which mean, radial, and axial diffusivity (MD, RD, AD, respectively), fractional anistrotropy (FA), mean and radial kurtosis (MK and RK, respectively), and kurtosis anisotropy (KA) maps were extracted. Associations of each metric with biochemical markers were explored through tract-based spatial statistics followed by threshold-free cluster enhancement. RESULTS We found significant positive associations between Nadir-CD4 values and both KA and FA, and significant negative associations between Nadir-CD4 values and MD. Also, we found significant positive associations among %CD4 and MK, KA, and FA, and significant negative associations among %CD4 values and MD. These associations were bilateral and involved predominantly the long association fibers. Anatomically, these associations were more widespread when using KA as compared to FA. No statistically significant associations with HIV-RNA concentrations were found. CONCLUSIONS In HIV-positive subjects, associations between biochemical and diffusion-MRI variables are found along the association fibers, which connect brain areas involved in memory formation, providing a possible interpretation for the neurobiological substrate underlying cognitive disturbances in HIV.
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Affiliation(s)
- Francesco Garaci
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,San Raffaele Cassino, FR, Italy
| | - Eliseo Picchi
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Medical Physics Section, Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Guglielmo Manenti
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Minosse S, Floris R, Nucci C, Toschi N, Garaci F, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Mancino R, Guerrisi M. Disruption of brain network organization in primary open angle glaucoma. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2019:4338-4341. [PMID: 31946828 DOI: 10.1109/embc.2019.8857290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Resting-state functional magnetic resonance imaging (rs-fMRI) is commonly employed to study changes in functional brain connectivity. Recently, the hypothesis of a brain involvement in primary open angle glaucoma has sprung interest for neuroimaging studies in this pathology. The purpose of this study is to evaluate a putative reorganization of brain networks in glaucomatous patients through graph-theoretical measures of integration, segregation and centrality by exploiting a multivariate networks association measure and a recently introduced global and local brain network disruption index. Nineteen glaucoma patients and sixteen healthy control subjects (age: 50 - 76, mean 61 years) underwent rs-fMRI examination at 3T. After preprocessing, rs-fMRI time series were parcellated into 116 regions (AAL atlas), adjacency matrices were computed based on partial correlations and graph-theoretical measures of integration, segregation and centrality as well as group-wise and subject-wise disruption index estimates were generated for all subjects. We found that the group-wise disruption index was negative and statistically different from 0 in for all graph theoretical metrics. Additionally, statistically significant group-wise differences in subject-wise disruption indexes were found in all local metrics. The differences in local network measures highlight cerebral reorganization of brain networks in glaucoma patients, supporting the interpretation of glaucoma as central nervous system disease, likely part of the heterogeneous group of recently described disconnection syndromes.
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Strigari L, Minosse S, D'Alessio D, Farina L, Cavagnaro M, Cassano B, Pinto R, Vallati G, Lopresto V. Microwave thermal ablation using CT-scanner for predicting the variation of ablated region over time: advantages and limitations. Phys Med Biol 2019; 64:115021. [PMID: 30995620 DOI: 10.1088/1361-6560/ab1a67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study aims at investigating in real-time the structural and dynamical changes occurring in an ex vivo tissue during a microwave thermal ablation (MTA) procedure. The experimental set-up was based on ex vivo liver tissue inserted in a dedicated box, in which 3 fibre-optic (FO) temperature probes were introduced to measure the temperature increase over time. Computed tomography (CT) imaging technique was exploited to experimentally study in real-time the Hounsfield Units (HU) modification occurring during MTA. The collected image data were processed with a dedicated MATLAB tool, developed to analyse the FO positions and HU modifications from the CT images acquired over time before and during the ablation procedures. The radial position of a FO temperature probe (rFO) and the value of HU in the region of interest (ROI) containing the probe (HUo), along with the corresponding value of HU in the contralateral ROI with respect to the MTA antenna applicator (HUc), were determined and registered over time during and after the MTA procedure. Six experiments were conducted to confirm results. The correlation between temperature and the above listed predictors was investigated using univariate and multivariate analysis. At the multivariate analysis, the time, rFO and HUc resulted significant predictive factors of the logarithm of measured temperature. The correlation between predicted and measured temperatures was 0.934 (p < 0.001). The developed tool allows identifying and registering the image-based parameters useful for predicting the temperature variation over time in each investigated voxel by taking into consideration the HU variation.
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Affiliation(s)
- L Strigari
- Laboratory of Medical Physics and Expert Systems, IRCCS Regina Elena National Cancer Institute, IFO, via Elio Chianesi, 53, 00144, Rome, Italy. Current address: Department of Medical Physics, St. Orsola-Malpighi University Hospital, via Massarenti 9 40138 Bologna, Italy
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Picchi E, Di Giuliano F, Marziali S, Minosse S, Ferrazzoli V, Da Ros V, Gaziev J, Pistolese CA, Floris R, Garaci F. Radiological findings of Posterior Reversible Encephalopathy Syndrome in transplanted children previous affected by hemoglobinopathy: A neuroimaging retrospective analysis. Eur J Radiol Open 2019; 6:144-151. [PMID: 31016209 PMCID: PMC6468159 DOI: 10.1016/j.ejro.2019.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/17/2019] [Indexed: 11/15/2022] Open
Abstract
To evaluate, by Magnetic Resonance Imaging, if there is a typical pattern or severity of PRES in transplanted children for hemoglobinopathy. Secondary point was to investigate the pattern and severity of PRES in children with thalassemia-THAL and sickle-cell disease-SCD after autologous hematopoietic stem cell transplantation (aHSCT). Finally, we evaluate the presence of atypical PRES presentation and the involved area of central nervous system. Two neuroradiologists analyzed retrospectively MRI of 21 transplanted children for THAL or SCD treated with CI, with neurological symptoms and signs of PRES. The Bartynski and Boardman classification has been used for PRES pattern while McKinney scale for PRES severity. Fisher Exact Probability test or Chi-square test were used to compare the categorical data. In the 21 transplanted children the PRES severity was typically mild (85.7%) without preferring radiological pattern at MRI. The analysis didn't show significant association between PRES pattern or PRES severity and previous hemoglobinopathy (THAL or SCD). No atypical PRES presentation has been found. PRES severity in transplanted children for hemoglobinopathy is typically mild. Notwithstanding children affected by SCD have a damage on the capillary endothelium, after aHSCT our data didn't show a different PRES severity and pattern than THAL children.
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Affiliation(s)
- Eliseo Picchi
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Francesca Di Giuliano
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Simone Marziali
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Valentina Ferrazzoli
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Valerio Da Ros
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Javid Gaziev
- International Center for Transplantation in Thalassemia and Sickle Cell Anemia. Mediterranean Institute ofHematology, University Hospital of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Francesco Garaci
- Diagnostic Imaging and Neuroradiology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
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Da Ros V, Cortese J, Chassin O, Rouchaud A, Sarov M, Caroff J, Mihalea C, Minosse S, Taifas I, Scaggiante J, Greco L, Ikka L, Ben Achour N, Di Giuliano F, Ozanne A, Legris N, Diomedi M, Sallustio F, Floris R, Denier C, Spelle L. Thrombectomy or intravenous thrombolysis in patients with NIHSS of 5 or less? J Neuroradiol 2019; 46:225-230. [PMID: 30659890 DOI: 10.1016/j.neurad.2019.01.089] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/03/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND PURPOSE To compare outcomes of minor stroke patients with intracranial vessel occlusions (IVO) underwent mechanical thrombectomy (MT) versus those treated with intravenous thrombolysis alone (IVT). METHODS We retrospectively reviewed two large prospective stroke databases from two European centers searching for patients admitted with minor stroke (i.e. NIHSS Score░≤░5), baseline mRS░=░0 and occlusion of the M1-M2 segment of the middle cerebral artery (MCA). Groups receiving (A) IVT alone and (B) MT+/-IVT were compared. Primary outcome measures were MT safety, successful recanalization rate (mTICI 2b-3) and NIHSS shift (discharge NIHSS minus admission NIHSS); secondary outcomes included discharge rates and excellent outcome (mRS 0-1) at 3 months. Univariate and multivariate analyses were performed. RESULTS Thirty-two patients were enrolled in Group B (19░MT alone; 13 MT░+░IVT) and 24 in Group A. Successful recanalization (mTICI 2b-3) was obtained in 100% of cases in Group B vs 38% in Group A. Symptomatic hemorrhagic transformation rate did not differ between the two groups. Multivariate analysis reported MT as the only predictor of early (<░12░h) favorable NIHSS shift and lower NIHSS at discharge. Moreover, discharge at home and excellent outcome at 3-month follow-up were statistically associated with MT. CONCLUSIONS MT in patients with minor strokes and intracranial vessel occlusion (IVO) is safe and can determine a rapid improvement of NIHSS Score. MT seems also associated with a higher rate of patients discharged at home after hospitalization and better clinical outcome at 3-month follow-up. Larger randomized trials are warranted to confirm these results.
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Affiliation(s)
- Valerio Da Ros
- Department of diagnostic imaging and interventional radiology, "Tor Vergata" university Hospital, viale Oxford, 81, 00133 Rome, Italy; Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France.
| | - Jonathan Cortese
- Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Olivier Chassin
- Department of Neurology, Bicêtre Hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, Paris, France
| | - Aymeric Rouchaud
- Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Mariana Sarov
- Department of Neurology, Bicêtre Hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, Paris, France
| | - Jildaz Caroff
- Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Cristian Mihalea
- Department of diagnostic imaging and interventional radiology, "Tor Vergata" university Hospital, viale Oxford, 81, 00133 Rome, Italy; Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Silvia Minosse
- Department of diagnostic imaging and interventional radiology, "Tor Vergata" university Hospital, viale Oxford, 81, 00133 Rome, Italy
| | - Irina Taifas
- Department of Neurology, Bicêtre Hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, Paris, France
| | - Jacopo Scaggiante
- Department of diagnostic imaging and interventional radiology, "Tor Vergata" university Hospital, viale Oxford, 81, 00133 Rome, Italy
| | - Laura Greco
- Department of diagnostic imaging and interventional radiology, "Tor Vergata" university Hospital, viale Oxford, 81, 00133 Rome, Italy
| | - Leon Ikka
- Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Nidhal Ben Achour
- Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Francesca Di Giuliano
- Department of diagnostic imaging and interventional radiology, "Tor Vergata" university Hospital, viale Oxford, 81, 00133 Rome, Italy
| | - Augustin Ozanne
- Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Nicolas Legris
- Department of Neurology, Bicêtre Hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, Paris, France
| | - Marina Diomedi
- Department of Neurology, Stroke Unit, "Tor Vergata" University Hospital, viale Oxford, 81, 00133 Rome, Italy
| | - Fabrizio Sallustio
- Department of Neurology, Stroke Unit, "Tor Vergata" University Hospital, viale Oxford, 81, 00133 Rome, Italy
| | - Roberto Floris
- Department of diagnostic imaging and interventional radiology, "Tor Vergata" university Hospital, viale Oxford, 81, 00133 Rome, Italy
| | - Christian Denier
- Department of Neurology, Bicêtre Hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, Paris, France
| | - Laurent Spelle
- Interventional Neuroradiology NEURI Center, Hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin Bicêtre, France
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Minosse S, Pisano A, Petrarca M, Favetta M, Romano A, Summa S, Castelli E. 293. Exploring the biomechanical constraints in different pathologies with gait analysis. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Marzi S, Minosse S, Vidiri A, Piludu F, Giannelli M. Diffusional kurtosis imaging in head and neck cancer: On the use of trace-weighted images to estimate indices of non-Gaussian water diffusion. Med Phys 2018; 45:5411-5419. [PMID: 30317646 DOI: 10.1002/mp.13238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE While previous studies have demonstrated the feasibility and potential usefulness of quantitative non-Gaussian diffusional kurtosis imaging (DKI) of the brain, more recent research has focused on oncological application of DKI in various body regions such as prostate, breast, and head and neck (HN). Given the need to minimize scan time during most routine magnetic resonance imaging (MRI) acquisitions of body regions, diffusion-weighted imaging (DWI) with only three orthogonal diffusion weighting directions (x, y, z) is usually performed. Moreover, as water diffusion within malignant tumors is generically thought to be almost isotropic, DWI with only three diffusion weighting directions is considered sufficient for oncological application and it represents the de facto standard in body DKI. In this context, since the kurtosis tensor and diffusion tensor cannot be obtained, the averages of the three directional (Kx , Ky , Kz ) and (Dx , Dy , Dz ) - namely K and D, respectively - represent the best-possible surrogates of directionless DKI-derived indices of kurtosis and diffusivity, respectively. This would require fitting the DKI model to the diffusion-weighted images acquired along each direction (x, y, z) prior to averaging. However, there is a growing tendency to perform only a single fit of the DKI model to the geometric means of the images acquired with diffusion-sensitizing gradient along (x, y, z), referred to as trace-weighted (TW) images. To the best of our knowledge, no in vivo studies have evaluated how TW images affect estimates of DKI-derived indices of K and D. Thus, the aim of this study was to assess the potential bias and error introduced in estimated K and D by fitting the DKI model to the TW images in HN cancer patients. METHODS Eighteen patients with histologically proven malignant tumors of the HN were enrolled in the study. They underwent pretreatment 3 T MRI, including DWI (b-values: 0, 500, 1000, 1500, 2000 s/mm2 ). Some patients had multiple lesions, and thus a total of 34 lesions were analyzed. DKI-derived indices were estimated, voxel-by-voxel, using single diffusion-weighted images along (x, y, z) as well as TW images. A comparison between the two estimation methods was performed by calculating the percentage error in D (Derr ) and K (Kerr ). Also, diffusivity anisotropy (Danis ) and diffusional kurtosis anisotropy (Kanis ) were estimated. Agreements between the two estimation methods were assessed by Bland-Altman plots. The Spearman rank correlation test was used to study the correlations between Kerr /Derr and Danis /Kanis. RESULTS: The median (95% confidence interval) Kerr and Derr were 5.1% (0.8%, 32.6%) and 1.7% (-2.5%, 5.3%), respectively. A significant relationship was observed between Kerr and Danis (correlation coefficient R = 0.694, P < 0.0001), as well as between Kerr and Kanis (R = 0.848, P < 0.0001). CONCLUSIONS In HN cancer, the fit of the DKI model to TW images can introduce bias and error in the estimation of K and D, which may be non-negligible for single lesions, and should hence be adopted with caution.
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Affiliation(s)
- Simona Marzi
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Silvia Minosse
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Antonello Vidiri
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Francesca Piludu
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", 56126, Pisa, Italy
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Di Giuliano F, Picchi E, Sallustio F, Ferrazzoli V, Alemseged F, Greco L, Minosse S, Da Ros V, Diomedi M, Garaci F, Marziali S, Floris R. Accuracy of advanced CT imaging in prediction of functional outcome after endovascular treatment in patients with large-vessel occlusion. Neuroradiol J 2018; 32:62-70. [PMID: 30303448 DOI: 10.1177/1971400918805710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Computed tomography perfusion (CTP) and multiphase CT angiography (mCTA) help selection for endovascular treatment (EVT) in anterior ischemic stroke (AIS). Our aim was to investigate the ability of perfusion maps and collateral score to predict functional outcome after EVT. PATIENTS AND METHODS Patients with M1-middle cerebral artery occlusion, evaluated by mCTA and CTP and treated with EVT within six hours of onset, were enrolled. Perfusion parametric maps of cerebral blood flow (CBF), cerebral blood volume (CBV) and time to maximum of tissue residue function ( Tmax) were generated; areas of altered perfusion were manually outlined to obtain volumes CBFv, CBVv, Tmax,v16-25s and Tmax,v9.5-25s . Diffusion-weighted imaging (DWI) at 24-36 hours was used to manually outline the ischemic core (volume: DWIv). Collateral vessels were assessed on mCTA considering extent and delay of maximal enhancement (six-point scale). Functional outcome was evaluated by modified Rankin Scale score at three months. Volumes in good and poor outcome groups were compared by Wilcoxon rank-sum test t, and their discriminative ability for outcome was determined by receiver operating characteristic analysis. A logistic regression model, including Tmax, CBF and collaterals, was used to differentiate good and poor outcome. RESULTS Seventy-one patients (mean age 75 ± 11 years, range 45-99 years) were included. Tmax,v16-25s , Tmax,v9.5-25s , CBVv, CBFv and DWIv were statistically different between the two groups. CBF had the best discriminative value for good and poor outcome (area under the curve (AUC) 0.73; 64.5% sensitivity; 74.4% specificity); the logistic regression model might be promising (AUC 0.79, 64.5% sensitivity, 82.1% specificity). CONCLUSIONS In patients with AIS, the combined use of CTP and mCTA predicts functional outcome of EVT and might allow better selection.
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Affiliation(s)
| | - Eliseo Picchi
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Fabrizio Sallustio
- 2 Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Italy
| | | | - Fana Alemseged
- 2 Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Italy.,3 Department of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Australia
| | - Laura Greco
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Silvia Minosse
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Valerio Da Ros
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Marina Diomedi
- 2 Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Italy.,4 I.R.C.C.S., Santa Lucia Foundation, Italy
| | - Francesco Garaci
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Simone Marziali
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
| | - Roberto Floris
- 1 Department of Biomedicine and Prevention, University of Tor Vergata, Italy
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Vidiri A, Minosse S, Piludu F, Pellini R, Cristalli G, Kayal R, Carlino G, Renzi D, Covello R, Marzi S. Cervical lymphadenopathy: can the histogram analysis of apparent diffusion coefficient help to differentiate between lymphoma and squamous cell carcinoma in patients with unknown clinical primary tumor? Radiol Med 2018; 124:19-26. [PMID: 30196522 DOI: 10.1007/s11547-018-0940-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 09/03/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE To retrospectively evaluate the value of whole-lesion histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating between lymphoma and metastatic squamous cell carcinoma (SCC) of unknown clinical primary in neck nodes. METHODS A total of 39 patients, 20 affected by lymphoma and 19 affected by metastatic non-nasopharyngeal SCC, were included in this retrospective study. All patients underwent MR imaging with a 1.5 T scanner system, including diffusion-weighted imaging (DWI) with three different b values (b = 0, 500 and 800 s/mm2). The entire tumor volume was manually delineated on the ADC maps, using the T2-weighted images and DWIs with b = 800 s/mm2 as a guide to the lesion location. The Mann-Whitney rank-sum test for independent samples was performed to compare the histogram parameters of patients with lymphoma and SCC. RESULTS The SCCs showed significantly higher median ADC (ADCmedian) and mean ADC (ADCmean) values, compared to lymphomas (p < 0.001), while they exhibited lower kurtosis and skewness without reaching significance (p = 0.066 and 0.148, respectively). The ADCmean and ADCmedian had the best discriminative powers for differentiating lymphoma and SCC, with an area under the curve of 87% and 85%, respectively. The optimal cutoff values for ADCmean and ADCmedian as predictors for lymphoma were ≤ 0.83 × 10-3 mm2/s and ≤ 0.73 × 10-3 mm2/s, respectively. CONCLUSIONS The whole-lesion ADC histogram analysis of cervical lymphadenopathy may help to discriminate lymphomas from non-nasopharyngeal SCC in patients with unknown clinical primary tumor.
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Affiliation(s)
- Antonello Vidiri
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy. .,, Via Pieve di Cadore 30, 00135, Rome, Italy.
| | - Silvia Minosse
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Francesca Piludu
- Department of Radiology, F. Policlinico Gemelli - IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Raul Pellini
- Department of Otolaryngology and Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Giovanni Cristalli
- Department of Otolaryngology and Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Ramy Kayal
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Giorgio Carlino
- Department of Radiology, F. Policlinico Gemelli - IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Daniela Renzi
- Department of Hematology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Renato Covello
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Simona Marzi
- Medical Physics Laboratory, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
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Lopresto V, Strigari L, Farina L, Minosse S, Pinto R, D’Alessio D, Cassano B, Cavagnaro M. CT-based investigation of the contraction ofex vivotissue undergoing microwave thermal ablation. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1361-6560/aaaf07] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Vidiri A, Minosse S, Piludu F, Curione D, Pichi B, Spriano G, Marzi S. Feasibility study of reduced field of view diffusion-weighted magnetic resonance imaging in head and neck tumors. Acta Radiol 2017; 58:292-300. [PMID: 27287402 DOI: 10.1177/0284185116652014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Reduced field of view (rFOV) imaging may be used to improve the quality of diffusion-weighted imaging (DWI) in the head and neck (HN) region. Purpose To evaluate the feasibility of rFOV-DWI in patients affected by HN tumors, through a comparison with conventional full FOV (fFOV) DWI. Material and Methods Twenty-two patients with histologically-proven malignant or benign tumors of the head and neck were included in a retrospective study. All patients underwent pre-treatment magnetic resonance imaging (MRI) studies including rFOV-DWI and fFOV-DWI. The apparent diffusion coefficient (ADC) value distributions inside tumor and muscle were derived and the mean, standard deviation (SD), and kurtosis were calculated. Image distortion was quantitatively and qualitatively evaluated, as well as the capability of lesion identification. The Wilcoxon test was used to compare all variables. Agreements between the ADC estimations were assessed by Bland-Altman plots. Results Image distortion and lesion identification scores were both higher for rFOV-DWI compared to fFOV-DWI. A reduction in ADC values with rFOV-DWI emerged for both lesion and muscle, with a mean percentage difference in ADC of 6.2% in the lesions and 24.9% in the muscle. The difference in SD of ADC was statistically significant in the lesions, indicating a higher ADC homogeneity for rFOV DWI ( P = 0.005). Conclusion The application of rFOV DWI in patients affected by HN tumors is feasible and promising, based on both qualitative and quantitative analyses. This technique has potential for improving the diagnostic accuracy of fFOV-DWI for the study of specific tumoral areas.
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Affiliation(s)
- Antonello Vidiri
- Radiology and Diagnostic Imaging Department, Regina Elena National Cancer Institute, Rome, Italy
| | - Silvia Minosse
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Rome, Italy
| | | | - Davide Curione
- Radiology Department, Catholic University of Rome, Rome, Italy
| | - Barbara Pichi
- Department of Otolaryngology Head and Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Spriano
- Department of Otolaryngology Head and Neck Surgery, Regina Elena National Cancer Institute, Rome, Italy
| | - Simona Marzi
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Rome, Italy
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Strolin S, Minosse S, D'Andrea M, Fracchiolla F, Bruzzaniti V, Luppino S, Benassi M, Strigari L. Zero field PDD and TMR data for unflattened beams in conventional linacs: A tool for independent dose calculations. Phys Med 2016; 32:1621-1627. [PMID: 27876285 DOI: 10.1016/j.ejmp.2016.11.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To investigate the applicability of the formalism described in BJR supplement n.25 for Flattening Filter Free (FFF) beams in determining the zero-field tissue maximum ratio (TMR) for an independent calculation method of Percentage Depth Doses (PDDs) and relative dose factors (RDFs) at different experimental setups. METHODS Experimental PDDs for field size from 40×40cm2 to 2×2cm2 with Source Surface Distance (SSD) 100cm were acquired. The normalized peak scatter factor for each square field was obtained by fitting experimental RDFs in water and collimator factors (CFs) in air. Maximum log-likelihood methods were used to extract fit parameters in competing models and the Bayesian Information Criterion was used to select the best one. In different experimental setups additional RDFs and TPR1020s for field sizes other than reference field were measured and Monte Carlo simulations of PDDs at SSD 80cm were carried out to validate the results. PDD agreements were evaluated by gamma analysis. RESULTS The BJR formalism allowed to predict the PDDs obtained with MC within 2%/2mm at SSD 80cm from 100% down to 50% of the maximum dose. The agreement between experimental TPR1020s and RDFs values at SSD=90cm and BJR calculations were within 1% for field sizes greater than 5×5cm2 while it was within 3% for fields down to 2×2cm2. CONCLUSIONS BJR formalism can be used for FFF beams to predict PDD and RDF at different SSDs and can be used for independent MU calculations.
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Affiliation(s)
- Silvia Strolin
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Silvia Minosse
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Marco D'Andrea
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Francesco Fracchiolla
- Azienda Provinciale per i Servizi Sanitari (APSS), Protontherapy Department, Trento, Italy
| | - Vicente Bruzzaniti
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Stefano Luppino
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Marcello Benassi
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Lidia Strigari
- Medical Physics Laboratory, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
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Strigari L, Pinnarò P, Carlini P, Torino F, Strolin S, Minosse S, Sanguineti G, Benassi M. Efficacy and mucosal toxicity of concomitant chemo-radiotherapy in patients with locally-advanced squamous cell carcinoma of the head-and-neck in the light of a novel mathematical model. Crit Rev Oncol Hematol 2016; 102:101-10. [PMID: 27157527 DOI: 10.1016/j.critrevonc.2016.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 03/22/2016] [Accepted: 04/14/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND In the last several decades, combined radiotherapy (RT) and chemotherapy (CT) have been recognized as feasible in locally-advanced-squamous-cell-carcinoma of the head-and-neck (LA-HNSCC). Several meta-analyses identified concurrent RT+CT (CRT) most likely effective approach respect to RT-alone. However, radiobiological models comparing different chemotherapeutic schedules against delivered RT fractionation schedule for overall survival and toxicity are still needed. METHODS AND MATERIALS Based on 9 randomized trials (2785 patients), radiobiological models and multivariate logistic regression model were used to derive dose-response curves and estimate the 5-year-overall survival (OS) and ≥G3 acute mucositis rate of CRT or RT-alone. RESULTS Equivalent dose at 2 Gy/fraction (EQD2) was calculated using the linear quadratic model. The effect of CRT schedules, considering the CT type and its administration schedule and the HPV status of tumors were estimated using the univariate/multivariate logistic regression. The multivariate logistic regression model for 5y-OS indicated EQD2 and the type of CT, the chemo-sensitization fraction and the HPV status significant prognostic factors, while for toxicity both EQD2 and the concomitant administration of 5-fluorouracil (5Fu) resulted as significant prognostic factors. Combined schedules cisplatin (DDP)+/-5Fu+RT produced the higher OS compared with combined carboplatin+/-5Fu+RT or RT-alone. The concomitant administration of Fu and schedule with high EQD2 increase the rate of observed ≥G3 acute mucositis. CONCLUSION Multivariate logistic regression models can be used to predict CRT effect in terms of OS and ≥G3-mucositis, contributing to the identification of novel treatment schedules.
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Affiliation(s)
- Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome, Italy.
| | - Paola Pinnarò
- Department of Radiation Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Carlini
- Department of Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Torino
- Department of Systems Medicine, Chair of Medical Oncology, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Strolin
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome, Italy
| | - Silvia Minosse
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Marcello Benassi
- Medical Physics Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, FC, Italy
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Minosse S, D'Alessio D, Lopresto V, Pinto R, Farina L, Cavagnaro M, Strigari L. CT-based monitoring of microwave thermal ablation. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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