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Amami P, Prioni S, Fusar Poli M, Pascuzzo R, Bocchi E, Golfrè Andreasi N, Devigili G, Cilia R, Rinaldo S, Levi V, Ghielmetti F, Grisoli M, Gemma M, DiMeco F, Eleopra R, Piacentini S. Pain related to MRgFUS: a merely minor transient adverse event? J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333401. [PMID: 38641369 DOI: 10.1136/jnnp-2024-333401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/29/2024] [Indexed: 04/21/2024]
Affiliation(s)
- Paolo Amami
- Clinical Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Sara Prioni
- Clinical Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Marco Fusar Poli
- Clinical Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Riccardo Pascuzzo
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Elisa Bocchi
- Clinical Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Nico Golfrè Andreasi
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Grazia Devigili
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Roberto Cilia
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Sara Rinaldo
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Vincenzo Levi
- Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Francesco Ghielmetti
- Medical Physics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Marina Grisoli
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Marco Gemma
- Intensive Care and Neuroanesthesia Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Francesco DiMeco
- Department of Neurological Surgery, Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta, Milano, Italy
- Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milano, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Sylvie Piacentini
- Clinical Neuropsychology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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2
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Golfrè Andreasi N, Braccia A, Levi V, Rinaldo S, Ghielmetti F, Cilia R, Romito LM, Bonvegna S, Elia AE, Devigili G, Telese R, Colucci F, Bruzzone MG, Messina G, Corradi M, Stanziano M, Caldiera V, Prioni S, Amami P, Fusar Poli M, Piacentini SHMJ, Grisoli M, Ciceri EFM, DiMeco F, Eleopra R. The Optimal Targeting for Focused Ultrasound Thalamotomy Differs between Dystonic and Essential Tremor: A 12-Month Prospective Pilot Study. Mov Disord Clin Pract 2024; 11:69-75. [PMID: 38291839 PMCID: PMC10828621 DOI: 10.1002/mdc3.13911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/02/2023] [Accepted: 10/10/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is increasingly used to treat drug-resistant essential tremor (ET). Data on MRgFUS thalamotomy in dystonic tremor (DT) are anecdotal. OBJECTIVES To investigate efficacy, safety, and differences in target coordinates of MRgFUS thalamotomy in DT versus ET. METHODS Ten patients with DT and 35 with ET who consecutively underwent MRgFUS thalamotomy were followed for 12 months. Although in both groups the initial surgical planning coordinates corresponded to the ventralis intermediate (Vim), the final target could be modified intraoperatively based on clinical response. RESULTS Tremor significantly improved in both groups. The thalamic lesion was significantly more anterior in DT than ET. Considering both ET and DT groups, the more anterior the lesion, the lower the odds ratio for adverse events. CONCLUSIONS MRgFUS thalamotomy is safe and effective in DT and ET. Compared to classical Vim coordinates used for ET, more anterior targeting should be considered for DT.
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Affiliation(s)
- Nico Golfrè Andreasi
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Arianna Braccia
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Vincenzo Levi
- Functional Neurosurgery Unit, Department of NeurosurgeryFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | - Sara Rinaldo
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | | | - Roberto Cilia
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Luigi Michele Romito
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Salvatore Bonvegna
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
- Present address:
Parkinson Institute, ASST Gaetano Pini‐CTOMilanItaly
| | - Antonio Emanuele Elia
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Grazia Devigili
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Roberta Telese
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Fabiana Colucci
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | | | - Giuseppe Messina
- Functional Neurosurgery Unit, Department of NeurosurgeryFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | - Marta Corradi
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
| | - Mario Stanziano
- Neuroradiology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
- Neuroscience Department “Rita Levi Montalcini”University of TurinTurinItaly
| | - Valentina Caldiera
- Diagnostic Radiology and Interventional NeuroradiologyFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | - Sara Prioni
- Clinical Neuropsychology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | - Paolo Amami
- Clinical Neuropsychology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | - Marco Fusar Poli
- Clinical Neuropsychology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | | | - Marina Grisoli
- Neuroradiology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | - Elisa Francesca Maria Ciceri
- Diagnostic Radiology and Interventional NeuroradiologyFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
| | - Francesco DiMeco
- Department of NeurosurgeryFondazione IRCCS Istituto Neurologico Carlo BestaMilanoItaly
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanoItaly
- Hunterian Brain Tumor Research LaboratoryDepartment of Neurological Surgery, Johns Hopkins Medical SchoolBaltimoreMarylandUSA
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Department of Clinical NeurosciencesFondazione IRCCS Istituto Neurologico Carlo BestMilanoItaly
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3
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Golfrè Andreasi N, Cilia R, Romito LM, Bonvegna S, Straccia G, Elia AE, Novelli A, Messina G, Tringali G, Levi V, Devigili G, Rinaldo S, Gasparini V, Grisoli M, Stanziano M, Ghielmetti F, Prioni S, Bocchi E, Amami P, Piacentini SHMJ, Ciceri EFM, Bruzzone MG, Eleopra R. Magnetic Resonance-Guided Focused Ultrasound Thalamotomy May Spare Dopaminergic Therapy in Early-Stage Tremor-Dominant Parkinson's Disease: A Pilot Study. Mov Disord 2022; 37:2289-2295. [PMID: 36036203 DOI: 10.1002/mds.29200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is a safe and effective procedure for drug-resistant tremor in Parkinson's disease (PD). OBJECTIVE The aim of this study was to demonstrate that MRgFUS ventralis intermedius thalamotomy in early-stage tremor-dominant PD may prevent an increase in dopaminergic medication 6 months after treatment compared with matched PD control subjects on standard medical therapy. METHODS We prospectively enrolled patients with early-stage PD who underwent MRgFUS ventralis intermedius thalamotomy (PD-FUS) and patients treated with oral dopaminergic therapy (PD-ODT) with a 1:2 ratio. We collected demographic and clinical data at baseline and 6 and 12 months after thalamotomy. RESULTS We included 10 patients in the PD-FUS group and 20 patients in the PD-ODT group. We found a significant increase in total levodopa equivalent daily dose and levodopa plus monoamine oxidase B inhibitors dose in the PD-ODT group 6 months after thalamotomy. CONCLUSIONS In early-stage tremor-dominant PD, MRgFUS thalamotomy may be useful to reduce tremor and avoid the need to increase dopaminergic medications. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Nico Golfrè Andreasi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Roberto Cilia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Luigi Michele Romito
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Salvatore Bonvegna
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Giulia Straccia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Antonio Emanuele Elia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Alessio Novelli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Giuseppe Messina
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurosurgery Department, Functional Neurosurgery Unit, Milan, Italy
| | - Giovanni Tringali
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurosurgery Department, Functional Neurosurgery Unit, Milan, Italy
| | - Vincenzo Levi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurosurgery Department, Functional Neurosurgery Unit, Milan, Italy
| | - Grazia Devigili
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Sara Rinaldo
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Valentina Gasparini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
| | - Marina Grisoli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neuroradiology Unit, Milan, Italy
| | - Mario Stanziano
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neuroradiology Unit, Milan, Italy.,Neuroscience Department "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Francesco Ghielmetti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Health Department, Milan, Italy
| | - Sara Prioni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Clinical Neuropsychology Unit, Milan, Italy
| | - Elisa Bocchi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Clinical Neuropsychology Unit, Milan, Italy
| | - Paolo Amami
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Clinical Neuropsychology Unit, Milan, Italy
| | | | - Elisa Francesca Maria Ciceri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Diagnostic Radiology and Interventional Neuroradiology, Milan, Italy
| | - Maria Grazia Bruzzone
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neuroradiology Unit, Milan, Italy
| | - Roberto Eleopra
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy
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Stanziano M, Golfrè Andreasi N, Messina G, Rinaldo S, Palermo S, Verri M, Demichelis G, Medina JP, Ghielmetti F, Bonvegna S, Nigri A, Frazzetta G, D'Incerti L, Tringali G, DiMeco F, Eleopra R, Bruzzone MG. Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study. Front Neurol 2022; 12:786734. [PMID: 35095731 PMCID: PMC8791196 DOI: 10.3389/fneur.2021.786734] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022] Open
Abstract
Magnetic Resonance-guided high-intensity Focused Ultrasound (MRgFUS) of the thalamic ventral intermediate nucleus (Vim) for tremor has increasingly gained interest as a new non-invasive alternative to standard neurosurgery. Resting state functional connectivity (rs-FC) correlates of MRgFUS have not been extensively investigated yet. A region of interest (ROI)-to-ROI rs-FC MRI “connectomic” analysis focusing on brain regions relevant for tremor was conducted on 15 tremor-dominant patients with Parkinson's disease who underwent MRgFUS. We tested whether rs-FC between tremor-related areas was modulated by MRgFUS at 1 and 3 months post-operatively, and whether such changes correlated with individual clinical outcomes assessed by the MDS-UPDRS-III sub items for tremor. Significant increase in FC was detected within bilateral primary motor (M1) cortices, as well as between bilateral M1 and crossed primary somatosensory cortices, and also between pallidum and the dentate nucleus of the untreated hemisphere. Correlation between disease duration and FC increase at 3 months was found between the putamen of both cerebral hemispheres and the Lobe VI of both cerebellar hemispheres, as well as between the Lobe VI of untreated cerebellar hemisphere with bilateral supplementary motor area (SMA). Drop-points value of MDS-UPDRS at 3 months correlated with post-treatment decrease in FC, between the anterior cingulate cortex and bilateral SMA, as well as between the Lobe VI of treated cerebellar hemisphere and the interpositus nucleus of untreated cerebellum. Tremor improvement at 3 months, expressed as percentage of intra-subject MDS-UPDRS changes, correlated with FC decrease between bilateral occipital fusiform gyrus and crossed Lobe VI and Vermis VI. Good responders (≥50% of baseline tremor improvement) showed reduced FC between bilateral SMA, between the interpositus nucleus of untreated cerebellum and the Lobe VI of treated cerebellum, as well as between the untreated SMA and the contralateral putamen. Good responders were characterized at baseline by crossed hypoconnectivity between bilateral putamen and M1, as well as between the putamen of the treated hemisphere and the contralateral SMA. We conclude that MRgFUS can effectively modulate brain FC within the tremor network. Such changes are associated with clinical outcome. The shifting mode of integration among the constituents of this network is, therefore, susceptible to external redirection despite the chronic nature of PD.
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Affiliation(s)
- Mario Stanziano
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.,Neurosciences Department "Rita Levi Montalcini, " University of Turin, Turin, Italy
| | - Nico Golfrè Andreasi
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Messina
- Functional Neurosurgery Unit, Neurosurgery Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Rinaldo
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Palermo
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.,European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
| | - Mattia Verri
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Greta Demichelis
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Jean Paul Medina
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesco Ghielmetti
- Health Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Salvatore Bonvegna
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Nigri
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Ludovico D'Incerti
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giovanni Tringali
- Functional Neurosurgery Unit, Neurosurgery Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesco DiMeco
- Neurosurgery Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.,Pathophysiology and Transplantation Department, University of Milan, Milan, Italy.,Neurological Surgery Department, Johns Hopkins Medical School, Baltimore, MD, United States
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
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5
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Ferrari M, Lizio D, Ghielmetti F, Fumagalli M, Sarati C, De Martin E, Verri M, Torresin A. MR-guided laser-induced thermal therapy: the role of medical physicist in implementation. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Gallo P, Fumagalli M, Ghielmetti F, Padelli F, Pascuzzo R, De Martin E, Bruzzone M. Potential role of dual-energy CT in brain imaging: accuracy of iodine concentrations. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00224-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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7
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De Martin E, Alhujaili S, Fumagalli ML, Ghielmetti F, Marchetti M, Gallo P, Aquino D, Padelli F, Davis J, Alnaghy S, Carrara M, Fariselli L, Rosenfeld AB, Petasecca M. On the evaluation of edgeless diode detectors for patient-specific QA in high-dose stereotactic radiosurgery. Phys Med 2021; 89:20-28. [PMID: 34343763 DOI: 10.1016/j.ejmp.2021.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE In this work, the potential of an innovative "edgeless" silicon diode was evaluated as a response to the still unmet need of a reliable tool for plan dosimetry verification of very high dose, non-coplanar, patient-specific radiosurgery treatments. In order to prove the effectiveness of the proposed technology, we focused on radiosurgical treatments for functional disease like tremor or pain. METHODS The edgeless diodes response has been validated with respect to clinical practice standard detectors by reproducing the reference dosimetry data adopted for the Treatment Planning System. In order to evaluate the potential for radiosurgery patient-specific treatment plan verification, the anthropomorphic phantom Alderson RANDO has been adopted along with three edgeless sensors, one placed in the centre of the Planning Target Volume, one superiorly and one inferiorly. RESULTS The reference dosimetry data obtained from the edgeless detectors are within 2.6% for output factor, off-axis ratio and well within 2% for tissue phantom ratio when compared to PTW 60,018 diode. The edgeless detectors measure a dose discrepancy of approximately 3.6% from the mean value calculated by the TPS. Larger discrepancies are obtained in very steep gradient dose regions when the sensors are placed outside the PTV. CONCLUSIONS The angular independent edgeless diode is proposed as an innovative dosimeter for patient quality assurance of brain functional disorders and other radiosurgery treatments. The comparison of the diode measurements with TPS calculations confirms that edgeless diodes are suitable candidates for patient-specific dosimetric verification in very high dose ranges delivered by non-isocentric stereotactic radiosurgery modalities.
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Affiliation(s)
- Elena De Martin
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Health Department, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Sultan Alhujaili
- Centre for Medical Radiation Physics, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia; Medical Imaging Department, College of Applied Medical Sciences, Aljouf University, Aljouf 72388, Saudi Arabia.
| | - Maria Luisa Fumagalli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Health Department, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Francesco Ghielmetti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Health Department, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Marcello Marchetti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Radiotherapy Unit, Department of Neurosurgery, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Pasqualina Gallo
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Health Department, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Domenico Aquino
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neuroradiology Unit, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Francesco Padelli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Neuroradiology Unit, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Jeremy Davis
- Centre for Medical Radiation Physics, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Saree Alnaghy
- Centre for Medical Radiation Physics, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Mauro Carrara
- Fondazione IRCCS Istituto Nazionale Dei Tumori, s.s.d. di Fisica Medica, Dipartimento di Diagnostica per Immagini e Radioterapia, Via Giacomo Venezian 1, 20133 Milan, Italy.
| | - Laura Fariselli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Radiotherapy Unit, Department of Neurosurgery, Via Giovanni Celoria 11, 20133 Milan, Italy.
| | - Anatoly B Rosenfeld
- Centre for Medical Radiation Physics, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Marco Petasecca
- Centre for Medical Radiation Physics, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
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Pinzi V, Marchetti M, De Martin E, Cuccarini V, Tramacere I, Ghielmetti F, Fumagalli ML, Iezzoni C, Fariselli L. Multisession radiosurgery for intracranial meningioma treatment: study protocol of a single arm, monocenter, prospective trial. Radiat Oncol 2020; 15:26. [PMID: 32000819 PMCID: PMC6993396 DOI: 10.1186/s13014-020-1478-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background Single session radiosurgery represents a widely accepted treatment for intracranial meningiomas. However, this approach could involve a high risk of treatment-related complications when applied to large volume lesions. In these cases and for those not suitable for surgical resection, radiosurgery in multisession setting could represents a viable option. The literature results are reassuring in terms of correlated adverse events as well as in terms of tumor control. However, no prospective long-term results are available. In this scenario, we design a prospective monocentric phase II study, in order to verify the safety of a multisession radiosurgery schedule delivering 25 Gy in 5 daily fractions. Methods Patients diagnosed with large and/or near to critical structures, intracranial meningiomas have been treated by means of multisession radiosurgery in both exclusive and postoperative settings. The primary study aim is safety that has been being prospectively scored based on international scales, including NCI Common Toxicity criteria, version 4.03, Barrow Neurological Institute pain intensity score, Barrow Neurological Institute facial numbness score and House-Brackmann Facial Nerve Grading System for qualitative analysis. Secondary aim is treatment efficacy in terms of local control that has been being assessed on volumetric analysis. Discussion This is the first prospective phase II trial on multisession radiosurgery for large and/or near to critical structures intracranial meningiomas. If positive results will be found, this study could represent the starting point for a phase III trial exploring the role of multisession radiosurgery in the exclusive and postoperative radiation therapy treatment of intracranial meningiomas. Trial registration Trial registration: clinicaltrials.gov platform (Multisession Radiosurgery in Large Meningiomas –MuRaLM- identifier NCT02974127). Registered: November 28, 2016. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02974127?term=radiosurgery&cond=Intracranial+Meningioma&draw=2&rank=1
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Affiliation(s)
- V Pinzi
- Neurosurgery Department, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - M Marchetti
- Neurosurgery Department, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - E De Martin
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - V Cuccarini
- Unit of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
| | - I Tramacere
- Department of Research and Clinical Development, Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - F Ghielmetti
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M L Fumagalli
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - C Iezzoni
- Neurosurgery Department, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - L Fariselli
- Neurosurgery Department, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Gallo P, De Martin E, Fumagalli M, Ghielmetti F, Carrara M, Alhujaili S, Lerch M, Rosenfeld A, Marchetti M, Fariselli L, Petasecca M. EP-2091 How to measure high dose in functional disorder treatment: an innovative silicon diode detector. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Russomando A, Schiariti M, Bocci V, Colandrea M, Collamati F, Cremonesi M, Ferrari M, Ferroli P, Ghielmetti F, Ghisini R, Grana C, Mancini Terracciano C, Marafini M, Mirabelli R, Morganti S, Papi S, Patanè M, Pedroli G, Pollo B, Solfaroli Camillocci E, Traini G, Faccini R. The β- radio-guided surgery: Method to estimate the minimum injectable activity from ex-vivo test. Phys Med 2019; 58:114-120. [DOI: 10.1016/j.ejmp.2019.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/21/2019] [Accepted: 02/09/2019] [Indexed: 11/16/2022] Open
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Gallo P, De Martin E, Marchetti M, Fumagalli M, Ghielmetti F, Alhujaili S, Lerch M, Carrara M, Rosenfeld A, Fariselli L, Petasecca M. 157. Verification of high dose delivery in radiosurgery management of brain functional disorders. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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13
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Camillocci ES, Mancini-Terracciano C, Bertani E, Bocci V, Colandrea M, Collamati F, Cremonesi M, Ferrari ME, Ferroli P, Ghielmetti F, Grana CM, Marafini M, Morganti S, Papi S, Patane’ M, Pedroli G, Pisa E, Pollo B, Schiariti M, Traini G, Faccini R. [OA109] Validation of a radio-guided surgery technique based on beta-radiation: Test on ex-vivo specimens. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.06.181] [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: 12/01/2022] Open
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Rosazza C, Deleo F, D'Incerti L, Antelmi L, Tringali G, Didato G, Bruzzone MG, Villani F, Ghielmetti F. Tracking the Re-organization of Motor Functions After Disconnective Surgery: A Longitudinal fMRI and DTI Study. Front Neurol 2018; 9:400. [PMID: 29922216 PMCID: PMC5996100 DOI: 10.3389/fneur.2018.00400] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/15/2018] [Indexed: 12/03/2022] Open
Abstract
Objective: Mechanisms of motor plasticity are critical to maintain motor functions after cerebral damage. This study explores the mechanisms of motor reorganization occurring before and after surgery in four patients with drug-refractory epilepsy candidate to disconnective surgery. Methods: We studied four patients with early damage, who underwent tailored hemispheric surgery in adulthood, removing the cortical motor areas and disconnecting the corticospinal tract (CST) from the affected hemisphere. Motor functions were assessed clinically, with functional MRI (fMRI) tasks of arm and leg movement and Diffusion Tensor Imaging (DTI) before and after surgery with assessments of up to 3 years. Quantifications of fMRI motor activations and DTI fractional anisotropy (FA) color maps were performed to assess the lateralization of motor network. We hypothesized that lateralization of motor circuits assessed preoperatively with fMRI and DTI was useful to evaluate the motor outcome in these patients. Results: In two cases preoperative DTI-tractography did not reconstruct the CST, and FA-maps were strongly asymmetric. In the other two cases, the affected CST appeared reduced compared to the contralateral one, with modest asymmetry in the FA-maps. fMRI showed different degrees of lateralization of the motor network and the SMA of the intact hemisphere was mostly engaged in all cases. After surgery, patients with a strongly lateralized motor network showed a stable performance. By contrast, a patient with a more bilateral pattern showed worsening of the upper limb function. For all cases, fMRI activations shifted to the intact hemisphere. Structural alterations of motor circuits, observed with FA values, continued beyond 1 year after surgery. Conclusion: In our case series fMRI and DTI could track the longitudinal reorganization of motor functions. In these four patients the more the paretic limbs recruited the intact hemisphere in primary motor and associative areas, the greater the chances were of maintaining elementary motor functions after adult surgery. In particular, DTI-tractography and quantification of FA-maps were useful to assess the lateralization of motor network. In these cases reorganization of motor connectivity continued for long time periods after surgery.
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Affiliation(s)
- Cristina Rosazza
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy.,Scientific Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Francesco Deleo
- Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Ludovico D'Incerti
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Luigi Antelmi
- Health Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Giovanni Tringali
- Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Giuseppe Didato
- Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Maria G Bruzzone
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Flavio Villani
- Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
| | - Francesco Ghielmetti
- Health Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy
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De Martin E, Duran D, Ghielmetti F, Visani E, Aquino D, Marchetti M, Sebastiano DR, Cusumano D, Bruzzone MG, Panzica F, Fariselli L. Integration of Functional Magnetic Resonance Imaging and Magnetoencephalography Functional Maps Into a CyberKnife Planning System: Feasibility Study for Motor Activity Localization and Dose Planning. World Neurosurg 2017; 108:756-762. [DOI: 10.1016/j.wneu.2017.08.187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/28/2017] [Accepted: 08/30/2017] [Indexed: 12/31/2022]
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Cusumano D, Fumagalli ML, Ghielmetti F, Rossi L, Grossi G, Lanzarotti R, Fariselli L, De Martin E. Sum signal dosimetry: A new approach for high dose quality assurance with Gafchromic EBT3. J Appl Clin Med Phys 2017; 18:181-190. [PMID: 28300373 PMCID: PMC5689947 DOI: 10.1002/acm2.12045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/17/2016] [Revised: 11/17/2016] [Accepted: 11/24/2016] [Indexed: 11/23/2022] Open
Abstract
Gafchromic EBT3 film dosimetry in radiosurgery (RS) and hypofractionated radiotherapy (HRT) is complicated by the limited film accuracy at high fractional doses. The aim of this study is to develop and evaluate sum signal (SS) film dosimetry to increase dose resolution at high fractional doses, thus allowing for use of EBT3 for dose distribution verification of RS/HRT treatments. To characterize EBT3 dose–response, a calibration was performed in the dose range 0.44–26.43 Gy. Red (RC) and green (GC) channel net optical densities were linearly added to produce the SS. Dose resolution and overall accuracy of the dosimetric protocol were estimated and compared for SS,RC, and GC. A homemade Matlab software was developed to compare, in terms of gamma analysis, dose distributions delivered by a Cyberknife on EBT3 films to dose distributions calculated by the treatment planning system. The new SS and conventional single channel (SC) methods were compared, using 3%/1 and 4%/1 mm acceptance criteria, for 20 patient plans. Our analysis shows that the SS dose–response curve is characterized by a steeper trend in comparison with SC, with SS providing a higher dose resolution in the whole dose range investigated. Gamma analysis confirms that the percentage of points satisfying the agreement criteria is significantly higher for SS compared to SC: 95.03% vs. 88.41% (P = 0.014) for 3%/1 mm acceptance criteria and 97.24% vs. 93.58% (P = 0.048) for 4%/1 mm acceptance criteria. This study demonstrates that the SS approach is a new and effective method to improve dosimetric accuracy in the framework of the RS‐HRT patient‐specific quality assurance protocol.
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Affiliation(s)
- Davide Cusumano
- School of Medical Physics, University of Milan, 20133, Milan, Italy
| | - Maria Luisa Fumagalli
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Francesco Ghielmetti
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Linda Rossi
- School of Medical Physics, University of Milan, 20133, Milan, Italy
| | - Giuliano Grossi
- Department of Computer Science, University of Milan, 20135, Milan, Italy
| | | | - Laura Fariselli
- Department of Neurosurgery, Radiotherapy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Elena De Martin
- Health Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
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Marchetti M, Pinzi V, Tramacere I, Bianchi LC, Ghielmetti F, Fariselli L. Radiosurgery for Paragangliomas of the Head and Neck: Another Step for the Validation of a Treatment Paradigm. World Neurosurg 2016; 98:281-287. [PMID: 27825903 DOI: 10.1016/j.wneu.2016.10.132] [Citation(s) in RCA: 8] [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: 09/19/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Paragangliomas are highly vascular and predominantly benign neoplasms that traditionally have been treated by surgery, embolization, and/or external beam radiotherapy. The aim of this study was to evaluate long-term local tumor control and the safety of radiosurgery for head and neck paragangliomas. METHODS Data were obtained from prospectively maintained databases of patients affected by brain tumors treated with radiosurgery at our institution. The inclusion criteria were histologically proven or radiologic-suspected diagnosis of paragangliomas; a follow-up period of at least 12 months, an magnetic resonance imaging-based tumor growth control analysis and a signed written consent. Twenty patients (21 paragangliomas) met the eligibility criteria and were included in the present study. All patients were clinically and radiologically evaluated before and after treatment. RESULTS The mean follow-up at the time of the present analysis was 46 months. Seven patients had a follow-up longer than 60 months. Seven lesions underwent a single-session radiosurgery with a mean dose of 12.2 Gy (range 11-13 Gy). Fourteen lesions underwent multisession radiosurgery with a mean dose of 25.7 Gy (range 20-30 Gy) delivered in 3-5 fractions. The mean tumor volume for single-session radiosurgery was 4 cc (range 1.4-9.2). The mean volume for multisession radiosurgery was 18.9 cc (range 1.3-50.9). None of the lesions showed progression on radiology during the follow-up period. Neurologic conditions generally are maintained or improved. CONCLUSIONS Both single and multisession radiosurgery were confirmed as a safe and effective treatment modality for paragangliomas. Multisession radiosurgery appears effective to treat large lesions.
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Affiliation(s)
- Marcello Marchetti
- Radiotherapy Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.
| | - Valentina Pinzi
- Radiotherapy Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Irene Tramacere
- Neuroepidemiology Unit, Health Department, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | | | | | - Laura Fariselli
- Radiotherapy Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
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Solfaroli Camillocci E, Schiariti M, Bocci V, Carollo A, Chiodi G, Colandrea M, Collamati F, Cremonesi M, Donnarumma R, Ferrari M, Ferroli P, Ghielmetti F, Grana C, Mancini Terracciano C, Marafini M, Morganti S, Patanè M, Pedroli G, Pollo B, Recchia L, Russomando A, Toppi M, Traini G, Faccini R. First ex vivo validation of a radioguided surgery technique withβ-radiation. Phys Med 2016; 32:1139-44. [DOI: 10.1016/j.ejmp.2016.08.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/21/2016] [Accepted: 08/23/2016] [Indexed: 10/21/2022] Open
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De Martin E, Duran D, Ghielmetti F, Visani E, Sebastiano D, Aquino D, Marchetti M, Cusumano D, Bruzzone M, Panzica F, Fariselli L. OC-0464: Integration of fMRI and MEG functional maps into a Cyberknife planning system:a feasibility study. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cusumano D, De Martin E, Duran D, Ghielmetti F, Visani E, Sebastiano DR, Aquino D, Marchetti M, Bruzzone M, Panzica F, Fariselli L. Integration of FMRI and MEG functional maps into a Cyberknife planning system: Feasibility study for motor activity localization and dose planning. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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21
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Nanetti L, Ferraro S, Bertolino N, Piacentini S, Mandelli M, Ghielmetti F, Castaldo A, Gellera C, Nigri A, Taroni F, Bruzzone M, Di Donato S, Grisoli M, Mariotti C. E25 Fmri Signal Changes In Frontal Cortex Correlates With Years-to-disease-onset In A Group Of Young Premanifest Huntington Disease Subjects. J Neurol Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bertolino N, Ferraro S, Nigri A, Bruzzone MG, Ghielmetti F. A neural network approach to fMRI binocular visual rivalry task analysis. PLoS One 2014; 9:e105206. [PMID: 25121595 PMCID: PMC4133376 DOI: 10.1371/journal.pone.0105206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 07/22/2014] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to investigate whether artificial neural networks (ANN) are able to decode participants’ conscious experience perception from brain activity alone, using complex and ecological stimuli. To reach the aim we conducted pattern recognition data analysis on fMRI data acquired during the execution of a binocular visual rivalry paradigm (BR). Twelve healthy participants were submitted to fMRI during the execution of a binocular non-rivalry (BNR) and a BR paradigm in which two classes of stimuli (faces and houses) were presented. During the binocular rivalry paradigm, behavioral responses related to the switching between consciously perceived stimuli were also collected. First, we used the BNR paradigm as a functional localizer to identify the brain areas involved the processing of the stimuli. Second, we trained the ANN on the BNR fMRI data restricted to these regions of interest. Third, we applied the trained ANN to the BR data as a ‘brain reading’ tool to discriminate the pattern of neural activity between the two stimuli. Fourth, we verified the consistency of the ANN outputs with the collected behavioral indicators of which stimulus was consciously perceived by the participants. Our main results showed that the trained ANN was able to generalize across the two different tasks (i.e. BNR and BR) and to identify with high accuracy the cognitive state of the participants (i.e. which stimulus was consciously perceived) during the BR condition. The behavioral response, employed as control parameter, was compared with the network output and a statistically significant percentage of correspondences (p-value <0.05) were obtained for all subjects. In conclusion the present study provides a method based on multivariate pattern analysis to investigate the neural basis of visual consciousness during the BR phenomenon when behavioral indicators lack or are inconsistent, like in disorders of consciousness or sedated patients.
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Affiliation(s)
- Nicola Bertolino
- Health Department, Carlo Besta Neurological Institute, Milan, Italy
- * E-mail:
| | - Stefania Ferraro
- Neuro-Radiology Department, Carlo Besta Neurological Institute, Milan, Italy
| | - Anna Nigri
- Neuro-Radiology Department, Carlo Besta Neurological Institute, Milan, Italy
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Ferraro S, Nanetti L, Piacentini S, Mandelli ML, Bertolino N, Ghielmetti F, Epifani F, Nigri A, Taroni F, Bruzzone MG, Di Donato S, Savoiardo M, Mariotti C, Grisoli M. Frontal cortex BOLD signal changes in premanifest Huntington disease: a possible fMRI biomarker. Neurology 2014; 83:65-72. [PMID: 24898924 DOI: 10.1212/wnl.0000000000000538] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify a possible functional imaging biomarker sensitive to the earliest neural changes in premanifest Huntington disease (preHD), allowing early therapeutic approaches aimed at preventing or delaying clinical onset. METHODS Sixteen preHD and 18 healthy participants were submitted to anatomical acquisitions and functional MRI (fMRI) acquisitions during the execution of the exogenous covert orienting of attention task. Due to strong a priori hypothesis, all fMRI correlation analyses were restricted to the following: (1) the frontal oculomotor cortex identified by the means of a prosaccadic task, comprising frontal eye fields and supplementary frontal eye fields; and (2) the data collected during inhibition of return, a phenomenon occurring during the executed task. In preHD, multiple regression analysis was performed between fMRI data and the probability to develop the disease in the next 5 years (p5HD). Moreover, mean blood oxygen level-dependent (BOLD) signal changes in the frontal oculomotor cortex and striatal volumes were linearly correlated with p5HD. RESULTS In preHD, multiple regression analysis showed that clusters of activity strongly correlated with p5HD in the right frontal oculomotor cortex. Importantly, mean BOLD signal changes of this region correlated with p5HD (r(2) = 0.52). Among the considered striatal volumes, a modest correlation (r(2) = 0.29) was observed in the right putamen and p5HD. CONCLUSION fMRI activations in the right-frontal oculomotor cortex during inhibition of return can be considered a possible functional imaging biomarker in preHD.
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Affiliation(s)
- Stefania Ferraro
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Lorenzo Nanetti
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco.
| | - Sylvie Piacentini
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Maria L Mandelli
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Nicola Bertolino
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Francesco Ghielmetti
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Francesca Epifani
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Anna Nigri
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Franco Taroni
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Maria G Bruzzone
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Stefano Di Donato
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Mario Savoiardo
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Caterina Mariotti
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
| | - Marina Grisoli
- From the Neuroradiology Department (S.F., F.G., F.E., A.N., M.G.B., M.S., M.G.), Unit of Genetics of Neurodegenerative and Metabolic Diseases, Clinical Pathology and Medical Genetics (L.N., F.T., S.D., C.M.), and Health Department (S.P., N.B., F.G.), Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy; and the Memory and Aging Center (M.L.M.), Department of Neurology, University of California San Francisco
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Bertolino N, Marchionni C, Ghielmetti F, Burns B, Finocchiaro G, Anghileri E, Bruzzone MG, Minati L. Accuracy of 2-hydroxyglutarate quantification by short-echo proton-MRS at 3 T: a phantom study. Phys Med 2014; 30:702-7. [PMID: 24685182 DOI: 10.1016/j.ejmp.2014.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 08/18/2013] [Revised: 12/19/2013] [Accepted: 03/04/2014] [Indexed: 02/07/2023] Open
Abstract
PURPOSE We set out to investigate the potential confounding effect of variable concentration of N-acetyl-l-aspartate (NAA) and Glutamate (Glu) on measurement of the brain oncometabolite 2-hydroxyglutarate (2HG) using a standard MRS protocol. This issue may arise due to spectral overlap at clinical magnetic field strengths and thus complicate the usage of 2HG as a putative biomarker of gliomas bearing mutations of the isocitrate dehydrogenase (IDH) 1 and 2 genes. METHODS Spectra from 25 phantoms (50 mL falcon test tubes) containing a range of known concentrations of 2HG, NAA and Glu were acquired using a clinical 3 T scanner with a quadrature head coil, single-voxel point-resolved spectroscopy sequence with TE = 30 ms. Metabolite concentrations were estimated by linear combination analysis and a simulated basis set. RESULTS NAA and Glu concentrations can have a significant confounding effect on 2HG measurements, whereby the negative changes in concentration of these metabolites typically observed in (peri)lesional areas can lead to under-estimation of 2HG concentration with respect to spectra acquired in presence of physiological levels of NAA and Glu. CONCLUSION The confounding effect of NAA and Glu concentration changes needs to be considered: in patients, it may mask the presence of 2HG at low concentrations, however it is not expected to lead to false positives. 2HG data acquired using standard short echo-time MRS protocols should be considered with caution.
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Affiliation(s)
- Nicola Bertolino
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | | | - Francesco Ghielmetti
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Brian Burns
- Department of Bioengineering, UCLA, Los Angeles CA, USA
| | - Gaetano Finocchiaro
- Molecular Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Elena Anghileri
- Molecular Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Maria Grazia Bruzzone
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Ludovico Minati
- Scientific Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
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Caputi L, Ghielmetti F, Faragò G, Longaretti F, Lamperti M, Anzola GP, Carriero MR, Charbel FT, Bruzzone MG, Parati E, Ciceri E. Cerebrovascular reactivity by quantitative magnetic resonance angiography with a Co₂ challenge. Validation as a new imaging biomarker. Eur J Radiol 2014; 83:1005-1010. [PMID: 24721002 DOI: 10.1016/j.ejrad.2014.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 03/03/2014] [Accepted: 03/06/2014] [Indexed: 11/16/2022]
Abstract
Assessment of cerebrovascular reactivity (CVR) is essential in cerebrovascular diseases, as exhausted CVR may enhance the risk of cerebral ischemic events. Transcranial Doppler (TCD) with a vasodilatory stimulus is currently used for CVR evaluation. Scanty data are available for Quantitative Magnetic Resonance Angiography (QMRA), which supplies higher spatial resolution and quantitative cerebral blood flow values. Aims of our pilot study were: (a) to assess safety and feasibility of CO2 administration during QMRA, (b) evaluation of CVR under QMRA compared to TCD, and (c) quantitative evaluation of blood flow from the major intracranial arterial vessels both at rest and after CO2. CVR during 5% CO2 air breathing was measured with TCD as a reference method and compared with QMRA. Fifteen healthy subjects (age 60.47 ± 2.24; male 11/15) were evaluated at rest and during CO2 challenge. Feasibility and safety of QMRA under CO2 were ensured in all subjects. CVR from middle cerebral artery territory was not statistically different between TCD and MRI (p>0.05). Mean arterial pressure (MAP) and heart rate (HR) increased during QMRA and TCD (MAP p=0.007 and p=0.001; HR p=0.043 and p=0.068, respectively). Blood flow values from all intracranial vessels increased after CO2 inhalation (p<0.001). CO2 administration during QMRA sessions is safe and feasible. Good correlation in terms of CVR was obtained comparing TCD and QMRA. Blood flow values significantly increased from all intracranial arterial vessels after CO2. Studies regarding CVR in physiopathological conditions might consider the utilization of QMRA both in routine clinical settings and in research projects.
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Affiliation(s)
- Luigi Caputi
- Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Francesco Ghielmetti
- Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Giuseppe Faragò
- Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Fabio Longaretti
- Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Massimo Lamperti
- Department of Neuroanesthesia and Intensive Care, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Gian Paolo Anzola
- Service of Neurology, S. Orsola Hospital, Fondazione Poliambulanza, Via Vittorio Emanuele II 27, 25122 Brescia, Italy.
| | - Maria Rita Carriero
- Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Fady T Charbel
- Department of Neurosurgery, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA.
| | - Maria Grazia Bruzzone
- Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Eugenio Parati
- Department of Cerebrovascular Diseases, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
| | - Elisa Ciceri
- Department of Neuroradiology, Fondazione IRCCS Neurological Institute C. Besta, Via Celoria 11, 20133 Milan, Italy.
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Rosazza C, Ghielmetti F, Minati L, Vitali P, Giovagnoli A, Deleo F, Didato G, Parente A, Marras C, Bruzzone M, D'Incerti L, Spreafico R, Villani F. Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance: An fMRI study. Neuroimage Clin 2013; 3:73-83. [PMID: 24179851 PMCID: PMC3807502 DOI: 10.1016/j.nicl.2013.07.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/31/2013] [Accepted: 07/01/2013] [Indexed: 11/15/2022]
Abstract
In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant. We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery. We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia. The key findings are:1)Both left and right TLE patients show decreased left lateralization compared to controls.2)Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.3)Left lateralization correlates with peri-ictal aphasia in left TLE patients.4)Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery. The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.
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Affiliation(s)
- C. Rosazza
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Scientific Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Ghielmetti
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Health Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - L. Minati
- Scientific Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - P. Vitali
- Brain MRI 3T Mondino Research Center, Istituto Neurologico “C. Mondino”, Pavia, Italy
| | - A.R. Giovagnoli
- Neuropsychology Laboratory, Dept. of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Deleo
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - G. Didato
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - A. Parente
- Neuropsychology Laboratory, Dept. of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - C. Marras
- Neurosurgery Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
- Dept. of Neuroscience Bambino Gesù Children Hospital, Rome, Italy
| | - M.G. Bruzzone
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - L. D'Incerti
- Neuroradiology Dept., Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - R. Spreafico
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
| | - F. Villani
- Division of Clinical Epileptology and Experimental Neurophysiology, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milano, Italy
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Berrini F, Pinzi V, Milanesi I, Santini B, De Simone A, Nicolato A, Ghielmetti F, Fariselli L. PO-0741: Neurocognitive status as QoL index in solitary brain metastasis patients treated with WBRT vs SRS after surgery. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33047-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ferraro S, Grazzi L, Muffatti R, Nava S, Ghielmetti F, Bertolino N, Mandelli ML, Visintin E, Bruzzone MG, Nigri A, Epifani F, Bussone G, Chiapparini L. In medication-overuse headache, fMRI shows long-lasting dysfunction in midbrain areas. Headache 2012; 52:1520-34. [PMID: 23094707 DOI: 10.1111/j.1526-4610.2012.02276.x] [Citation(s) in RCA: 53] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The primary aim of our study was to evaluate if a group of medication-overuse headache (MOH) patients present dysfunctions in the mesocorticolimbic dopamine circuit. The secondary aim was to disentangle the role of the medication overuse and of the acute/chronic headache in determining these alterations and to investigate their persistence. BACKGROUND Several researches have suggested that MOH may belong to the spectrum of addictive behavior. Preclinical models and neuroimaging studies have consistently demonstrated that in addiction, critical long-lasting alterations occur in the mesocorticolimbic dopamine circuit. If MOH shares some neurophysiological features with addiction, long-lasting functional alterations of the mesocorticolimbic dopamine system related to medication overuse should be present. METHODS We collected functional magnetic resonance imaging data during the execution of a decision-making under risk paradigm in 8 MOH patients immediately after beginning medication withdrawal, in 8 detoxified MOH patients at 6 months after beginning medication withdrawal, in 8 chronic migraine patients, and in 8 control subjects. RESULTS Our results revealed that MOH patients present: (1) reduced task-related activity in the substantia nigra/ventral tegmental area complex and increased activity in the ventromedial prefrontal cortex, when compared with controls; (2) reduced activity in the substantia nigra/ventral tegmental area complex, when compared with chronic migraine patients; (3) increased activity in the ventromedial prefrontal cortex, when compared with detoxified MOH patients. CONCLUSION Our study showed that MOH patients present dysfunctions in the mesocorticolimbic dopamine circuit, in particular in the ventromedial prefrontal cortex and in the substantia nigra/ventral tegmental area complex. The ventromedial prefrontal cortex dysfunctions seem to be reversible and attributable to the acute/chronic headache, whereas the substantia nigra/ventral tegmental area complex dysfunctions are persistent and possibly related to medication overuse. These dysfunctions might be the expression of long-lasting neuroadaptations related to the overuse of medications and/or a pre-existing neurophysiological condition leading to vulnerability to medication overuse. The observed persistent dysfunctions in the midbrain dopamine suggest that MOH may share some neurophysiological features with addiction.
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Affiliation(s)
- Stefania Ferraro
- Neuroradiology Department, Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy.
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29
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Rosazza C, Minati L, Ghielmetti F, Mandelli ML, Bruzzone MG. Functional connectivity during resting-state functional MR imaging: study of the correspondence between independent component analysis and region-of-interest-based methods. AJNR Am J Neuroradiol 2011; 33:180-7. [PMID: 21998099 DOI: 10.3174/ajnr.a2733] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE The connectivity across brain regions can be evaluated through fMRI either by using ICA or by means of correlation analysis of time courses measured in predefined ROIs. The purpose of this study was to investigate quantitatively the correspondence between the connectivity information provided by the 2 techniques. MATERIALS AND METHODS In this study, resting-state fMRI data from 40 healthy participants were independently analyzed by using spatial ICA and ROI-based analysis. To assess the correspondence between the results provided by the 2 methods, for all combinations of ROIs, we compared the time course correlation coefficient with the corresponding "ICA coactivation index." RESULTS A strongly significant correspondence of moderate intensity was found for 20 ICA components (r = 0.44, P < .001). Repeating the analysis with 10, 15, 25, 30, 35, and 40 components, we found that the correlation remained but was weaker (r = 0.35-0.41). CONCLUSIONS There is a significant but not complete correspondence between the results provided by ICA and ROI-based analysis of resting-state data.
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Affiliation(s)
- C Rosazza
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta," Milan, Italy.
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30
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Canazza A, Calatozzolo C, Fumagalli L, Bergantin A, Ghielmetti F, Fariselli L, Croci D, Salmaggi A, Ciusani E. Increased migration of a human glioma cell line after in vitro CyberKnife irradiation. Cancer Biol Ther 2011; 12:629-33. [PMID: 21775821 DOI: 10.4161/cbt.12.7.16862] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A human glioblastoma multiforme cell line (U87) and its derived-spheroids were irradiated either using a conventional irradiation (CIR) or a CK-like irradiation (IIR) in which the 8 Gy was delivered intermittently over a period of 40 minutes. The ability of glioma cells to migrate into a matrigel matrix was evaluated on days 1-8 from irradiation. Irradiation with CK-driven IIR significantly increased the invasion potential of U87 cells in a matrigel-based assay. In contrast to CIR, IIR was associated with increased levels of TGF-β at four days (Real time PCR), β1-integrin at 4-5 days (real-time PCR and western blot) and no elevation in phosphorylated AKT at days 4 and 5 (western blot). Our data suggests that glioma cell invasion as well as elevations of TGF-β and β1-integrin are associated with IIR and not CIR.
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Affiliation(s)
- Alessandra Canazza
- Laboratory of Clinical Investigation, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
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31
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Canazza A, De Grazia U, Fumagalli L, Brait L, Ghielmetti F, Fariselli L, Croci D, Salmaggi A, Ciusani E. In vitro effects of Cyberknife-driven intermittent irradiation on glioblastoma cell lines. Neurol Sci 2011; 32:579-88. [PMID: 21301910 DOI: 10.1007/s10072-011-0485-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 01/22/2011] [Indexed: 01/23/2023]
Abstract
Radiosurgery is used increasingly upon recurrence of high-grade gliomas to deliver a high dose of focused radiation to a defined target. The purpose of our study was to compare intermittent irradiation (IIR) by using a CyberKnife (CK) with continuous irradiation (CIR) by using a conventional linear accelerator (LINAC). A significant decrease in surviving fraction was observed after IIR irradiation compared with after CIR at a dose of 8 Gy. Three hours after irradiation, most of the DNA damage was repaired in U87. Slightly higher basal levels of Ku70/80 mRNA were found in U87 compared with A172, while radiation treatment induced only minor regulation of Ku70/80 and Rad51 transcription in either cell lines. IIR treatment using CK significantly decreased the survival in U87 and A172 compared with CIR. Although the two cell lines differed in DNA repair capability, the role of Ku70/80 and Rad51 in the cell line radiosensitivity seemed marginal.
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Affiliation(s)
- Alessandra Canazza
- Laboratory of Clinical Investigation, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
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32
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Vitali P, Dronkers N, Pincherle A, Giovagnoli AR, Marras C, D'Incerti L, Ghielmetti F, Spreafico R, Villani F. Accuracy of pre-surgical fMRI confirmed by subsequent crossed aphasia. Neurol Sci 2010; 32:175-80. [PMID: 21088978 DOI: 10.1007/s10072-010-0426-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 09/08/2010] [Indexed: 11/30/2022]
Abstract
Atypical patterns of language activation in functional MRI (fMRI) are not unusual, particularly in patients with severe epilepsy. Still, the functional significance of these activations is under debate. We describe a case of a right-handed patient affected by drug-refractory right temporal lobe epilepsy in whom pre-surgical fMRI showed bilateral language activations, greater in the right hemisphere (RH). After surgery, a right subdural hematoma caused epileptic status and severe aphasia. This post-surgical complication of a crossed aphasia confirmed the prior fMRI findings of RH language thus stressing the value of pre-surgical fMRI evaluations, even when surgery is planned in the RH of a right-handed patient.
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Affiliation(s)
- Paolo Vitali
- Division of Neuroradiology, Department of Diagnostics and Applied Technology, Foundation IRCCS National Neurological Institute C. Besta, Milan, Italy
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33
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Vitali P, Ghielmetti F, D'Incerti FL, Maccagnano C, Rosazza C, Giovagnoli AR, Marras C, Dylgieri S, Deleo F, Spreafico R, Bruzzone MG, Villani F. Presurgical assessment of language lateralization in temporal lobe during word fluency and response naming tasks. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71751-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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34
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Rosazza C, Minati L, Ghielmetti F, Maccagnano E, Erbetta A, Villani F, Epifani F, Spreafico R, Bruzzone MG. Engagement of the medial temporal lobe in verbal and nonverbal memory: assessment with functional MR imaging in healthy subjects. AJNR Am J Neuroradiol 2009; 30:1134-41. [PMID: 19357387 DOI: 10.3174/ajnr.a1518] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The hippocampus and parahippocampal gyrus have a central role in the acquisition of new memories. Although functional MR imaging (fMRI) can provide information on the functional status of these brain regions, it has not reached widespread use in the presurgical assessment of patients undergoing temporal lobectomy. We aimed to evaluate whether simple memory-encoding paradigms could be used to elicit robust activations in the hippocampus and parahippocampal gyrus and to determine the lateralization of verbal and nonverbal memory. We also studied the relative contribution of the anterior and posterior portions of these structures. MATERIALS AND METHODS We conducted this study on 16 healthy subjects by performing event-related fMRI using 3 memory encoding tasks with words, objects, and faces. In addition to a second-level group analysis, region-of-interest (ROI)-based measurements of the signal intensity percent change and of the percentage of activated voxels, determined at 2 thresholds, were performed. ROIs were drawn on the hippocampus and parahippocampal gyrus, divided into anterior and posterior segments. RESULTS We found overall left-lateralized activation with words, bilateral activation with objects, and right-lateralized activation with faces. In particular, significant hippocampal activations were observed with all 3 categories of stimuli, and the head of the hippocampus was generally more engaged than its body and tail. Data on the signal intensity percent change and percentage of activated voxels are provided for each ROI and task. CONCLUSIONS The combination of these 3 undemanding memory tasks could be considered, following appropriate validation, as a tool to assess the functional status of the medial temporal lobe in clinical settings.
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Affiliation(s)
- C Rosazza
- Scientific Department, Division of Clinical Epileptology, Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta, Milan, Italy.
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35
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Minati L, Ghielmetti F, Ciobanu V, D'Incerti L, Maccagnano C, Bizzi A, Bruzzone MG. Bio-image warehouse system: concept and implementation of a diagnosis-based data warehouse for advanced imaging modalities in neuroradiology. J Digit Imaging 2007; 20:32-41. [PMID: 16953339 PMCID: PMC3043890 DOI: 10.1007/s10278-006-0859-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 10/24/2022] Open
Abstract
Advanced neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), chemical shift spectroscopy imaging (CSI), diffusion tensor imaging (DTI), and perfusion-weighted imaging (PWI) create novel challenges in terms of data storage and management: huge amounts of raw data are generated, the results of analysis may depend on the software and settings that have been used, and most often intermediate files are inherently not compliant with the current DICOM (digital imaging and communication in medicine) standard, as they contain multidimensional complex and tensor arrays and various other types of data structures. A software architecture, referred to as Bio-Image Warehouse System (BIWS), which can be used alongside a radiology information system/picture archiving and communication system (RIS/PACS) system to store neuroimaging data for research purposes, is presented. The system architecture is conceived with the purpose of enabling to query by diagnosis according to a predefined two-layered classification taxonomy. The operational impact of the system and the time needed to get acquainted with the web-based interface and with the taxonomy are found to be limited. The development of modules enabling automated creation of statistical templates is proposed.
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Affiliation(s)
- L Minati
- Scientific Direction Unit, Istituto Nazionale Neurologico C. Besta, via Celoria, 11, I-20133, Milano, Italy.
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Gladin CR, Salsano E, Menghi F, Grisoli M, Ghielmetti F, Milanesi I, Pollo B, Brock S, Cusin A, Minati L, Finocchiaro G, Bruzzone MG. Loss of heterozygosity studies in extracranial metastatic meningiomas. J Neurooncol 2007; 85:81-5. [PMID: 17453146 DOI: 10.1007/s11060-007-9386-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2006] [Accepted: 03/30/2007] [Indexed: 11/28/2022]
Abstract
Although most meningiomas are slow-growing tumours associated with favourable prognosis, they often present local recurrence after surgical treatment; by contrast, extracranial metastatic meningiomas are rare, occurring in less than 1% of the cases. Risk factors for distal spread remain largely unknown. We report three cases with lung or bone metastases from intracranial recurrent meningiomas. Loss of heterozygosity (LOH) analysis on 1p, 9p, 10q, 14q, and 22q was conducted in available primary, recurrent and metastatic lesions, showing the same LOH pattern in the distal metastases and in the intracranial meningioma. LOH at 1p, 14q and 9p, known to be associated with increased aggressiveness, were found. The results highlight the potential clinical relevance of integrating histopathological studies with molecular genetic analysis in the follow-up of patients with different types of meningiomas.
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Affiliation(s)
- Caroline Regna Gladin
- Department of Experimental Neurology and Diagnostics, Fondazione IRCCS Istituto Neurologico Besta, Milano, Italy
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Pellegatta S, Poliani PL, Corno D, Menghi F, Ghielmetti F, Suarez-Merino B, Caldera V, Nava S, Ravanini M, Facchetti F, Bruzzone MG, Finocchiaro G. Neurospheres enriched in cancer stem-like cells are highly effective in eliciting a dendritic cell-mediated immune response against malignant gliomas. Cancer Res 2006; 66:10247-52. [PMID: 17079441 DOI: 10.1158/0008-5472.can-06-2048] [Citation(s) in RCA: 187] [Impact Index Per Article: 10.4] [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: 11/16/2022]
Abstract
Cancer stem-like cells (CSC) could be a novel target for cancer therapy, including dendritic cell (DC) immunotherapy. To address this, we developed experiments aimed at DC targeting of neurospheres (NS) from GL261 glioma cells because neurospheres can be enriched in CSC. We obtained murine neurospheres by growing GL261 cells in epidermal growth factor/basic fibroblast growth factor without serum. GL261-NS recapitulated important features of glioblastoma CSC and expressed higher levels of radial glia stem cell markers than GL261 cells growing under standard conditions (GL261 adherent cells, GL261-AC), as assessed by DNA microarray and real-time PCR. GL261-NS brain gliomas were highly infiltrating and more rapidly lethal than GL261-AC, as evidenced by survival analysis (P < 0.0001), magnetic resonance imaging and histology. DC from the bone marrow of syngeneic mice were then used for immunotherapy of GL261-NS and GL261-AC tumors. Strikingly, DC loaded with GL261-NS (DC-NS) cured 80% and 60% of GL261-AC and GL261-NS tumors, respectively (P < 0.0001), whereas DC-AC cured only 50% of GL261-AC tumors (P = 0.0022) and none of the GL261-NS tumors. GL261-NS expressed higher levels of MHC and costimulatory molecules (CD80 and CD86) than GL261-AC; the JAM assay indicated that DC-NS splenocytes had higher lytic activity than DC-AC splenocytes on both GL261-NS and GL261-AC, and immunohistochemistry showed that DC-NS vaccination was associated with robust tumor infiltration by CD8+ and CD4+ T lymphocytes. These findings suggest that DC targeting of CSC provides a higher level of protection against GL261 gliomas, a finding with potential implications for the design of clinical trials based on DC vaccination.
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Affiliation(s)
- Serena Pellegatta
- Units of Experimental Neuro-Oncology, Fondazione IRCCS Istituto Neurologico Besta, Milan, Italy
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Ghielmetti F, Colò G, Vigezzi E, Bortignon PF, Broglia RA. Spectral line shape of exotic nuclei. Phys Rev C Nucl Phys 1996; 54:R2143-R2145. [PMID: 9971646 DOI: 10.1103/physrevc.54.r2143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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