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Isella V, Licciardo D, Ferri F, Crivellaro C, Morzenti S, Appollonio IM, Ferrarese C. Left and right corticobasal syndrome: comparison of cognitive profiles between metabolic imaging - matched groups. Neurol Sci 2024; 45:1499-1506. [PMID: 37889380 PMCID: PMC10942890 DOI: 10.1007/s10072-023-07148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Corticobasal syndrome (CBS) is typically asymmetric. Case reports suggest that left-hemisphere CBS (lhCBS) is associated with major language impairment, and right-hemisphere CBS (rhCBS) is associated with major visuospatial deficits, but no group study has ever verified these observations. In our study, we enrolled 49 patients with CBS, classified them as lhCBS or rhCBS based on asymmetry of hypometabolism on brain FDG-PET and compared their cognitive and behavioural profiles. METHODS We defined asymmetry of hypometabolism upon visual inspection of qualitative PET images and confirmed it through paired comparison of left- and right-hemisphere FDG uptake values. The two groups were also matched for severity of hypometabolism within the more affected and more preserved hemispheres, to unravel differences in the cognitive profiles ascribable specifically to each hemisphere's functional specializations. All patients were assessed for memory, language, executive and visuospatial deficits, apraxia, neglect, dyscalculia, agraphia and behavioural disturbances. RESULTS LhCBS (n. 26) and rhCBS (n. 23) patients did not differ for demographics, disease duration and severity of global cognitive impairment. The two cognitive profiles were largely overlapping, with two exceptions: Digit span forward was poorer in lhCBS, and visual neglect was more frequent in rhCBS. CONCLUSIONS After balancing out patients for hemispheric hypometabolism, we did not confirm worse language or visuospatial deficits in, respectively, lhCBS and rhCBS. However, verbal short-term memory was more impaired in lhCBS, and spatial attention was more impaired in rhCBS. Both of these functions reflect the functional specialization of the left and right fronto-parietal pathways, i.e. of the main loci of neurodegeneration in CBS.
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Affiliation(s)
- Valeria Isella
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy.
| | - Daniele Licciardo
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
| | - Francesca Ferri
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
| | - Cinzia Crivellaro
- Fondazione IRCCS San Gerardo Dei Tintori (Nuclear Medicine), Monza, Italy
| | - Sabrina Morzenti
- Fondazione IRCCS San Gerardo Dei Tintori (Medical Physics), Monza, Italy
| | - Ildebrando Marco Appollonio
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
| | - Carlo Ferrarese
- School of Medicine and Surgery (Neurology), University of Milano-Bicocca, Via Cadore 48, 20900, Monza(MB), Italy
- Fondazione IRCCS San Gerardo Dei Tintori (Neurology), Monza, Italy
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Cerina V, Crivellaro C, Morzenti S, Pozzi FE, Bigiogera V, Jonghi-Lavarini L, Moresco RM, Basso G, De Bernardi E. A ROI-based quantitative pipeline for 18F-FDG PET metabolism and pCASL perfusion joint analysis: Validation of the 18F-FDG PET line. Heliyon 2024; 10:e23340. [PMID: 38163125 PMCID: PMC10755331 DOI: 10.1016/j.heliyon.2023.e23340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024] Open
Abstract
In Mild Cognitive Impairment (MCI), the study of brain metabolism, provided by 18F-FluoroDeoxyGlucose Positron Emission Tomography (18F-FDG PET) can be integrated with brain perfusion through pseudo-Continuous Arterial Spin Labeling Magnetic Resonance sequences (MR pCASL). Cortical hypometabolism identification generally relies on wide control group datasets; pCASL control groups are instead not publicly available yet, due to lack of standardization in the acquisition parameters. This study presents a quantitative pipeline to be applied to PET and pCASL data to coherently analyze metabolism and perfusion inside 16 matching cortical regions of interest (ROIs) derived from the AAL3 atlas. The PET line is tuned on 36 MCI patients and 107 healthy control subjects, to agree in identifying hypometabolic regions with clinical reference methods (visual analysis supported by a vendor tool and Statistical Parametric Mapping, SPM, with two parametrizations here identified as SPM-A and SPM-B). The analysis was conducted for each ROI separately. The proposed PET analysis pipeline obtained accuracy 78 % and Cohen's к 60 % vs visual analysis, accuracy 79 % and Cohen's к 58 % vs SPM-A, accuracy 77 % and Cohen's к 54 % vs SPM-B. Cohen's к resulted not significantly different from SPM-A and SPM-B Cohen's к when assuming visual analysis as reference method (p-value 0.61 and 0.31 respectively). Considering SPM-A as reference method, Cohen's к is not significantly different from SPM-B Cohen's к as well (p-value = 1.00). The complete PET-pCASL pipeline was then preliminarily applied on 5 MCI patients and metabolism-perfusion regional correlations were assessed. The proposed approach can be considered as a promising tool for PET-pCASL joint analyses in MCI, even in the absence of a pCASL control group, to perform metabolism-perfusion regional correlation studies, and to assess and compare perfusion in hypometabolic or normo-metabolic areas.
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Affiliation(s)
- Valeria Cerina
- PhD program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Cinzia Crivellaro
- Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Sabrina Morzenti
- Medical Physics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Federico E. Pozzi
- PhD program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Italy
- Neurology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
- Milan center for Neuroscience (NeuroMI), University of Milano-Bicocca, Italy
| | | | | | - Rosa M. Moresco
- School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Gianpaolo Basso
- Milan center for Neuroscience (NeuroMI), University of Milano-Bicocca, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Italy
- Neuroradiology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
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Elvevi A, Laffusa A, Elisei F, Morzenti S, Guerra L, Rovere A, Invernizzi P, Massironi S. Any role for transarterial radioembolization in unresectable intrahepatic cholangiocarcinoma in the era of advanced systemic therapies? World J Hepatol 2023; 15:1284-1293. [PMID: 38223418 PMCID: PMC10784807 DOI: 10.4254/wjh.v15.i12.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/27/2023] [Accepted: 12/05/2023] [Indexed: 12/25/2023] Open
Abstract
Intrahepatic cholangiocarcinoma (iCCA) is recognized as the second most frequently diagnosed liver malignancy, following closely after hepatocellular carcinoma. Its incidence has seen a global upsurge in the past several years. Unfortunately, due to the lack of well-defined risk factors and limited diagnostic tools, iCCA is often diagnosed at an advanced stage, resulting in a poor prognosis. While surgery is the only potentially curative option, it is rarely feasible. Currently, there are ongoing investigations into various treatment approaches for unresectable iCCA, including conventional chemotherapies, targeted therapies, immunotherapies, and locoregional treatments. This study aims to explore the role of transarterial radioembolization (TARE) in the treatment of unresectable iCCA and provide a comprehensive review. The findings suggest that TARE is a safe and effective treatment option for unresectable iCCA, with a median overall survival (OS) of 14.9 months in the study cohort. Studies on TARE for unresectable iCCA, both as a first-line treatment (as a neo-adjuvant down-staging strategy) and as adjuvant therapy, have reported varying median response rates (ranging from 34% to 86%) and median OS (12-16 mo). These differences can be attributed to the heterogeneity of the patient population and the limited number of participants in the studies. Most studies have identified tumor burden, portal vein involvement, and the patient's performance status as key prognostic factors. Furthermore, a phase 2 trial evaluated the combination of TARE and chemotherapy (cisplatin-gemcitabine) as a first-line therapy for locally advanced unresectable iCCA. The results showed promising outcomes, including a median OS of 22 mo and a 22% achievement in down-staging the tumor. In conclusion, TARE represents a viable treatment option for unresectable iCCA, and its combination with systemic chemotherapy has shown promising results. However, it is important to consider treatment-independent factors that can influence prognosis. Further research is necessary to identify optimal treatment combinations and predictive factors for a favorable response in iCCA patients.
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Affiliation(s)
- Alessandra Elvevi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza 20900, Italy
| | - Alice Laffusa
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza 20900, Italy
| | - Federica Elisei
- Department of Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori University of Milano Bicocca, Monza 20900, Italy
| | - Sabrina Morzenti
- Medical Physics, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
| | - Luca Guerra
- Department of Nuclear Medicine, Fondazione IRCCS San Gerardo dei Tintori University of Milano Bicocca, Monza 20900, Italy
| | - Antonio Rovere
- Department of Radiology and Interventional Radiology, Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza 20900, Italy
| | - Pietro Invernizzi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza 20900, Italy
| | - Sara Massironi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori Hospital, Monza 20900, Italy.
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Isella V, Licciardo D, Nastasi G, Impagnatiello V, Ferri F, Mapelli C, Crivellaro C, Musarra M, Morzenti S, Appollonio I, Ferrarese C. Clinical and metabolic imaging features of late-onset and early-onset posterior cortical atrophy. Eur J Neurol 2022; 29:3147-3157. [PMID: 35950612 PMCID: PMC9804481 DOI: 10.1111/ene.15520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/12/2022] [Accepted: 08/04/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Late-onset (LO) and early-onset (EO) dementia show neurobiological and clinical differences. Clinical and 18 fluoro-deoxy-glucose positron emission tomography (FDG-PET) features of LO and EO posterior cortical atrophy (LO_PCA, EO_PCA), the visual variant of Alzheimer's disease (AD), were compared. LO_PCA patients were also compared with a group of patients with LO typical AD (tAD). METHODS Thirty-seven LO_PCA patients (onset age ≥ 65 years), 29 EO_PCA patients and 40 tAD patients who all underwent a standard neuropsychological battery were recruited; PCA patients were also assessed for the presence of posterior signs and symptoms. Brain FDG-PET was available in 32 LO_PCA cases, 23 EO_PCA cases and all tAD cases, and their scans were compared with scans from 30 healthy elderly controls. Within the entire PCA sample FDG uptake was also correlated with age at onset as a continuous variable. RESULTS The main difference between the two PCA groups was a higher prevalence of Bálint-Holmes symptoms in EO cases, which was associated with the presence of severe bilateral occipito-temporo-parietal hypometabolism, whilst LO_PCA patients showed reduction of FDG uptake mainly in the right posterior regions. The latter group also showed mesial temporal hypometabolism, similarly to the tAD group, although with a right rather than left lateralization. Correlation analysis confirmed the association between older age and decreased limbic metabolism and between younger age and decreased left parietal metabolism. CONCLUSIONS The major involvement of the temporal cortex in LO cases and of the parietal cortex in EO cases reported previously within the AD spectrum holds true also for the visual variant of AD.
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Affiliation(s)
- Valeria Isella
- Neurology, School of MedicineUniversity of Milano—BicoccaMonzaItaly,Milan Center for NeurosciencesNeuroMIMilanItaly
| | - Daniele Licciardo
- Milan Center for NeurosciencesNeuroMIMilanItaly,Neurology DepartmentSan Gerardo HospitalMonzaLombardiaItaly
| | - Giulia Nastasi
- Neurology DepartmentASST of VimercateVimercateLombardiaItaly
| | - Valentina Impagnatiello
- Milan Center for NeurosciencesNeuroMIMilanItaly,Neurology DepartmentSan Gerardo HospitalMonzaLombardiaItaly
| | - Francesca Ferri
- Milan Center for NeurosciencesNeuroMIMilanItaly,Neurology DepartmentSan Gerardo HospitalMonzaLombardiaItaly
| | | | | | - Monica Musarra
- Nuclear Medicine UnitSan Gerardo HospitalMonzaLombardiaItaly
| | | | - Ildebrando Appollonio
- Neurology, School of MedicineUniversity of Milano—BicoccaMonzaItaly,Milan Center for NeurosciencesNeuroMIMilanItaly,Neurology DepartmentSan Gerardo HospitalMonzaLombardiaItaly
| | - Carlo Ferrarese
- Neurology, School of MedicineUniversity of Milano—BicoccaMonzaItaly,Milan Center for NeurosciencesNeuroMIMilanItaly,Neurology DepartmentSan Gerardo HospitalMonzaLombardiaItaly
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Isella V, Licciardo D, Ferri F, Crivellaro C, Morzenti S, Appollonio I, Ferrarese C. Reduced phonemic fluency in progressive supranuclear palsy is due to dysfunction of dominant BA6. Front Aging Neurosci 2022; 14:969875. [PMID: 36158541 PMCID: PMC9492952 DOI: 10.3389/fnagi.2022.969875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Reduced phonemic fluency is extremely frequent in progressive supranuclear palsy (PSP), but its neural correlate is yet to be defined. Objective We explored the hypothesis that poor fluency in PSP might be due to neurodegeneration within a dominant frontal circuit known to be involved in speech fluency, including the opercular area, the superior frontal cortex (BA6), and the frontal aslant tract connecting these two regions. Methods We correlated performance on a letter fluency task (F, A, and S, 60 s for each letter) with brain metabolism as measured with Fluoro-deoxy-glucose Positron Emission Tomography, using Statistical Parametric Mapping, in 31 patients with PSP. Results Reduced letter fluency was associated with significant hypometabolism at the level of left BA6. Conclusion Our finding is the first evidence that in PSP, as in other neurogical disorders, poor self-initiated, effortful verbal retrieval appears to be linked to dysfunction of the dominant opercular-aslant-BA6 circuit.
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Affiliation(s)
- Valeria Isella
- Department of Neurology, School of Medicine, University of Milano - Bicocca, Monza, Italy
- Milan Center for Neurosciences, Milan, Italy
| | - Daniele Licciardo
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
| | - Francesca Ferri
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
| | | | | | - Ildebrando Appollonio
- Department of Neurology, School of Medicine, University of Milano - Bicocca, Monza, Italy
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
| | - Carlo Ferrarese
- Department of Neurology, School of Medicine, University of Milano - Bicocca, Monza, Italy
- Milan Center for Neurosciences, Milan, Italy
- Neurology Unit, San Gerardo Hospital, Monza, Italy
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Isella V, Rosazza C, Ferri F, Gazzotti M, Impagnatiello V, Mapelli C, Morzenti S, Crivellaro C, Appollonio IM, Ferrarese C. Learning From Mistakes: Cognitive and Metabolic Correlates of Errors on Picture Naming in the Alzheimer’s Disease Spectrum. J Alzheimers Dis 2022; 87:1033-1053. [DOI: 10.3233/jad-220053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background: Analysis of subtypes of picture naming errors produced by patients with Alzheimer’s disease (AD) have seldom been investigated yet may clarify the cognitive and neural underpinnings of naming in the AD spectrum. Objective: To elucidate the neurocognitive bases of picture naming in AD through a qualitative analysis of errors. Methods: Over 1000 naming errors produced by 70 patients with amnestic, visuospatial, linguistic, or frontal AD were correlated with general cognitive tests and with distribution of hypometabolism on FDG-PET. Results: Principal component analysis identified 1) a Visual processing factor clustering visuospatial tests and unrecognized stimuli, pure visual errors and visual-semantic errors, associated with right parieto-occipital hypometabolism; 2) a Concept-Lemma factor grouping language tests and anomias, circumlocutions, superordinates, and coordinates, correlated with left basal temporal hypometabolism; 3) a Lemma-Phonology factor including the digit span and phonological errors, linked with left temporo-parietal hypometabolism. Regression of brain metabolism on individual errors showed that errors due to impairment of basic and higher-order processing of object visual attributes or of their interaction with semantics, were related with bilateral occipital and left occipito-temporal dysfunction. Omissions and superordinates were linked to degradation of broad and basic concepts in the left basal temporal cortex. Semantic-lexical errors derived from faulty semantically- and phonologically-driven lexical retrieval in the left superior and middle temporal gyri. Generation of nonwords was underpinned by of phonological impairment within the left inferior parietal cortex. Conclusion: Analysis of individual naming errors allowed to outline a comprehensive anatomo-functional model of picture naming in classical and atypical AD.
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Affiliation(s)
- Valeria Isella
- Department of Neurology, S. Gerardo Hospital, Monza, University of Milano - Bicocca, Italy
- NeuroMI, University of Milano - Bicocca, Italy
| | - Cristina Rosazza
- Dipartimento di Studi Umanistici (DISTUM), Università degli Studi di Urbino Carlo Bo, Urbino, Italy
- Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesca Ferri
- Department of Neurology, S. Gerardo Hospital, Monza, University of Milano - Bicocca, Italy
- NeuroMI, University of Milano - Bicocca, Italy
| | - Maria Gazzotti
- Department of Neurology, S. Gerardo Hospital, Monza, University of Milano - Bicocca, Italy
| | | | - Cristina Mapelli
- Department of Neurology, S. Gerardo Hospital, Monza, University of Milano - Bicocca, Italy
- NeuroMI, University of Milano - Bicocca, Italy
| | - Sabrina Morzenti
- Medical Physics, S. Gerardo Hospital, Monza, Italy
- NeuroMI, University of Milano - Bicocca, Italy
| | - Cinzia Crivellaro
- Nuclear Medicine, S. Gerardo Hospital, Monza, Italy
- NeuroMI, University of Milano - Bicocca, Italy
| | - Ildebrando M. Appollonio
- Department of Neurology, S. Gerardo Hospital, Monza, University of Milano - Bicocca, Italy
- NeuroMI, University of Milano - Bicocca, Italy
| | - Carlo Ferrarese
- Department of Neurology, S. Gerardo Hospital, Monza, University of Milano - Bicocca, Italy
- NeuroMI, University of Milano - Bicocca, Italy
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Isella V, Crivellaro C, Formenti A, Musarra M, Pacella S, Morzenti S, Ferri F, Mapelli C, Gallivanone F, Guerra L, Appollonio I, Ferrarese C. Validity of cingulate–precuneus–temporo-parietal hypometabolism for single-subject diagnosis of biomarker-proven atypical variants of Alzheimer’s Disease. J Neurol 2022; 269:4440-4451. [PMID: 35347453 PMCID: PMC9293827 DOI: 10.1007/s00415-022-11086-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/14/2022]
Abstract
The aim of our study was to establish empirically to what extent reduced glucose uptake in the precuneus, posterior cingulate and/or temporo-parietal cortex (PCTP), which is thought to indicate brain amyloidosis in patients with dementia or MCI due to Alzheimer’s Disease (AD), permits to distinguish amyloid-positive from amyloid-negative patients with non-classical AD phenotypes at the single-case level. We enrolled 127 neurodegenerative patients with cognitive impairment and a positive (n. 63) or negative (n. 64) amyloid marker (cerebrospinal fluid or amy-PET). Three rating methods of FDG-PET scan were applied: purely qualitative visual interpretation of uptake images (VIUI), and visual reading assisted by a semi-automated and semi-quantitative tool: INLAB, provided by the Italian National Research Council, or Cortex ID Suite, marketed by GE Healthcare. Fourteen scans (11.0%) patients remained unclassified by VIUI or INLAB procedures, therefore, validity values were computed on the remaining 113 cases. The three rating approaches showed good total accuracy (77–78%), good to optimal sensitivity (81–93%), but poorer specificity (62–75%). VIUI showed the highest sensitivity and the lowest specificity, and also the highest proportion of unclassified cases. Cases with asymmetric temporo-parietal hypometabolism and a progressive aphasia or corticobasal clinical profile, in particular, tended to be rated as AD-like, even if biomarkers indicated non-amyloid pathology. Our findings provide formal support to the value of PCTP hypometabolism for single-level diagnosis of amyloid pathophysiology in atypical AD, but also highlight the risk of qualitative assessment to misclassify patients with non-AD PPA or CBS underpinned by asymmetric temporo-parietal hypometabolism.
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De Ponti E, Crivellaro C, Morzenti S, Monaco L, Todde S, Landoni C, Elisei F, Musarra M, Guerra L. Clinical Application of a High Sensitivity BGO PET/CT Scanner: Effects of Acquisition Protocols and Reconstruction Parameters on Lesions Quantification. Curr Radiopharm 2022; 15:218-227. [PMID: 34994322 DOI: 10.2174/1874471015666220107100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/22/2022]
Abstract
AIMS The aim of this retrospective study was to investigate SUVs variability with respect to lesion size, administered dose, and reconstruction algorithm. BACKGROUND SUVmax and SUVpeak are influenced by technical factors as count statistics and reconstruction algorithms. OBJECTIVE To fulfill the aim, we evaluated the SUVs variability with respect to lesion size, administered dose, and reconstruction algorithm (ordered - subset expectation maximization plus point spread function option - OSEM+PSF, regularized Bayesian Penalized Likelihood - BPL) in a 5 - rings BGO PET/CT scanner. METHOD Discovery IQ scanner (GE Healthcare, Milwaukee, Wisconsin, US) was used for list mode acquisition of 25 FDG patients, 12 injected with 3.7 MBq/kg (Standard Dose protocol - SD) and 13 injected with 1.8 MBq/kg (Low Dose protocol - LD). Each acquisition was reconstructed at different time/FOV with both OSEM+PSF algorithm and BPL using seven different beta factors. SUVs were calculated in 70 lesions and analysed in function of time/FOV and Beta. Image quality was evaluated as a coefficient of variation of the liver (CV - liver). RESULT SUVs were not considerably affected by time/FOV. However, SUVs were influenced by beta: differences were higher in small lesions (37% for SUVmax, 15% for SUVpeak) compared to larger ones (14% and 6%). CV - liver ranged from 6% with Beta-500 (LD and SD) to 13% with Beta-200 (LD). CV - liver of BPL with Beta-350 (optimized for clinical practice in our institution) in LD was lower than CV - liver of OSEM+PSF in SD. CONCLUSION When a high sensitivity 5 - rings BGO PET/CT scanner is used with the same reconstruction algorithm, quantification by means of SUVmax and SUVpeak is a robust standard compared to the activity and scan duration. However, both SUVs and image quality are influenced by reconstruction algorithms and the related parameters should be considered to obtain the best compromise between detectability, quantification, and noise.
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Affiliation(s)
- Elena De Ponti
- Medical Physics Department, San Gerardo Hospital, ASST - Monza, Via Pergolesi 33, 20900, Monza (MB), Italy
| | - Cinzia Crivellaro
- Nuclear Medicine, ASST - Monza San Gerardo Hospital, 20900 Monza, Italy
| | - Sabrina Morzenti
- Medical Physics Department, San Gerardo Hospital, ASST - Monza, Via Pergolesi 33, 20900, Monza (MB), Italy
| | - Lavinia Monaco
- School of Medicine and Surgery, University of Milano - Bicocca, 20900 Monza, Italy
| | - Sergio Todde
- University of Milano - Bicocca, Tecnomed Foundation
| | - Claudio Landoni
- Nuclear Medicine, ASST - Monza San Gerardo Hospital, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano - Bicocca, 20900 Monza, Italy
| | - Federica Elisei
- Nuclear Medicine, ASST - Monza San Gerardo Hospital, 20900 Monza, Italy
| | - Monica Musarra
- Nuclear Medicine, ASST - Monza San Gerardo Hospital, 20900 Monza, Italy
| | - Luca Guerra
- Nuclear Medicine, ASST - Monza San Gerardo Hospital, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano - Bicocca, 20900 Monza, Italy
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Fedeli L, Belli G, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Bernardi L, Betti M, Caivano R, Carni M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliado G, Morzenti S, Niespolo A, Nocetti L, Noferini L, Oberhofer N, Orsingher L, Quattrocchi M, Ricci A, Savini A, Taddeucci A, Testa C, Tortoli P, Luchinat C, Tenori L, Gobbi G, Gori C, Busoni S, Mazzoni L. Multicenter comparison of MR scanners for quantitative diffusion weighted imaging: apparent diffusion coefficient dependence on acquisition plan and spatial position – preliminary results. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00475-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Belli G, Coniglio A, Bettarini S, Tortoli P, Fedeli L, Giannelli M, Mazzoni L, Nocetti L, Sghedoni R, Tarducci R, Belligotti E, Canzi C, Chiappiniello A, Cimolai S, Giovannini G, Lizio D, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Niespolo A, Noferini L, Oberhofer N, Origgi D, Paruccini N, Quattrocchi M, Savini A, Solla I, Taddeucci A, Busoni S. Multicentre comparison of MR scanners (15T, 3T) for MR T1-T2 relaxometry. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00490-2] [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: 11/15/2022] Open
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11
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Pacella S, Bonacina M, Morzenti S, Guerra L, De Ponti E, Crivellaro C, Landoni C, Messa MC. Cardiotoxicity in breast cancer patients: the role of gated myocardial perfusion SPECT. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Patients undergoing chemotherapy (CHT) for breast cancer (BC) need a monitoring of cardiac function due to the possible onset of cardiotoxicity. Cardiotoxicity may occur with heart failure but is often asymptomatic and is detectable only by assessing an increase in cardiac volumes (left ventricular end-diastolic (LV-EDV) and end-systolic (LV-ESV) volumes) and/or by a reduction of the left ventricular ejection fraction (LV-EF). The primary purpose of this study was to evaluate the role of gated SPECT myocardial perfusion imaging in this setting. Dosimetric evaluation was also assessed.
Methods
Seventeen BC patients (mean age 55.93 ± 11.04 years)with invasive ductal carcinoma HER2 + treated with surgery and with an anthracycline-based adjuvant CHT, were enrolled. The trend of cardiac function was assessed by evaluation of LV-EF, LV-EDV and LV-ESV using gSPECT in baseline conditions and at 12, 15 and 52 weeks during treatment and then at 6, 12, 24 and 48 months during follow-up. Each patient was studied 15-20 min after injection of 555 MBq of 99mTc-Tetrofosmin with gSPECT (16 frames/cardiac cycle) using an Infinia Hawkeye IV gamma-camera. Dosimetry was assed according to ICRP reports.
Results
Two out of the 17 patients enrolled left the protocol: one because of a second tumor and the other due to the appearance of cardiotoxicity. 15 patients completed the study: mean LVEF at baseline was 70.67 ± 5.68. The greatest modification occurred after 15th week of treatment, when mean LV-EF showed a significant decrease to 65.67 ± 8.27, while mean LV-EDV and mean LV-ESV increased from 73.60 ± 16.72 up to 84.73 ± 21.11 and from 21.93 ± 7.17 up to 30.27 ± 14.16, respectively. All parameters progressively returned similar to baseline values at the final examination (after 48th month): mean LV-EF 70.20 ± 5.65, LV-EDV 73.40 ± 16.15 and ESV 22.07 ± 7.50. In one case cardiotoxicity occurred at 15th week: LV-EF decreased from 69 to 47%, LV-EDV increased from 92 up to 142 ml and LV-ESV from 28 up to 75 ml. According to our image protocols, effective dose for gSPECT was 3.83 mSv (ICRP 106). The use of gSPET instead of MUGA (6.47 mSv–ICRP 80) allowed a dose effective saving of 2.64 mSv/each control with a total saving of 21.12 mSv/patient.
Conclusions
Although the small sample size, gSPECT was demonstrated to be an applicable tool for monitoring cardiac function because it correctly identified BC patient with cardiotoxicity. gSPECT also allowed a significant radiation dose saving compared to MUGA: this is particularly relevant in cardiotoxicity studies that require repeated and close evaluations.
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Affiliation(s)
- S Pacella
- Hospital ASST West Milanese, Legnano, Italy
| | - M Bonacina
- Clinical Institute Humanitas Gavazzeni, Nuclear Medicine Department, Bergamo, Italy
| | - S Morzenti
- San Gerardo Hospital, Medical Physics, Monza, Italy
| | - L Guerra
- University of Milan-Bicocca, Milan, Italy
| | - E De Ponti
- San Gerardo Hospital, Medical Physics, Monza, Italy
| | - C Crivellaro
- San Gerardo Hospital, Nuclear Medicine Department, Monza, Italy
| | - C Landoni
- University of Milan-Bicocca, Milan, Italy
| | - MC Messa
- University of Milan-Bicocca, Milan, Italy
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12
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Fedeli L, Benelli M, Busoni S, Belli G, Ciccarone A, Coniglio A, Esposito M, Nocetti L, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Bettarini S, Betti M, Caivano R, Carnì M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Niespolo A, Noferini L, Oberhofer N, Orsingher L, Quattrocchi M, Ricci A, Savini A, Taddeucci A, Testa C, Tortoli P, Gobbi G, Gori C, Bernardi L, Giannelli M, Mazzoni LN. On the dependence of quantitative diffusion-weighted imaging on scanner system characteristics and acquisition parameters: A large multicenter and multiparametric phantom study with unsupervised clustering analysis. Phys Med 2021; 85:98-106. [PMID: 33991807 DOI: 10.1016/j.ejmp.2021.04.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/31/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The purpose of this multicenter phantom study was to exploit an innovative approach, based on an extensive acquisition protocol and unsupervised clustering analysis, in order to assess any potential bias in apparent diffusion coefficient (ADC) estimation due to different scanner characteristics. Moreover, we aimed at assessing, for the first time, any effect of acquisition plan/phase encoding direction on ADC estimation. METHODS Water phantom acquisitions were carried out on 39 scanners. DWI acquisitions (b-value = 0-200-400-600-800-1000 s/mm2) with different acquisition plans (axial, coronal, sagittal) and phase encoding directions (anterior/posterior and right/left, for the axial acquisition plan), for 3 orthogonal diffusion weighting gradient directions, were performed. For each acquisition setup, ADC values were measured in-center and off-center (6 different positions), resulting in an entire dataset of 84 × 39 = 3276 ADC values. Spatial uniformity of ADC maps was assessed by means of the percentage difference between off-center and in-center ADC values (Δ). RESULTS No significant dependence of in-center ADC values on acquisition plan/phase encoding direction was found. Ward unsupervised clustering analysis showed 3 distinct clusters of scanners and an association between Δ-values and manufacturer/model, whereas no association between Δ-values and maximum gradient strength, slew rate or static magnetic field strength was revealed. Several acquisition setups showed significant differences among groups, indicating the introduction of different biases in ADC estimation. CONCLUSIONS Unsupervised clustering analysis of DWI data, obtained from several scanners using an extensive acquisition protocol, allows to reveal an association between measured ADC values and manufacturer/model of scanner, as well as to identify suboptimal DWI acquisition setups for accurate ADC estimation.
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Affiliation(s)
- Luca Fedeli
- S.O.C. Fisica Sanitaria Pistoia-Prato, A.U.S.L. Toscana Centro, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, A.U.S.L. Toscana Centro, Italy
| | - Simone Busoni
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy
| | - Giacomo Belli
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy
| | | | - Angela Coniglio
- Department of Medical Physics, P.O. S. Filippo Neri, Roma, Italy
| | - Marco Esposito
- S.C. Fisica Sanitaria Firenze-Empoli, A.U.S.L. Toscana Centro, Firenze, Italy
| | - Luca Nocetti
- Servizio di Fisica Medica, A.O.U. Policlinico di Modena, Modena, Italy
| | - Roberto Sghedoni
- Fisica Medica, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Luisa Altabella
- Medical Physics Department, Hospital of Trento, APSS, Trento, Italy
| | - Eleonora Belligotti
- Fisica Medica ed Alte Tecnologie, A.O. Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Silvia Bettarini
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy; Università degli Studi di Firenze, Firenze, Italy
| | - Margherita Betti
- S.O.C. Fisica Sanitaria Pistoia-Prato, A.U.S.L. Toscana Centro, Italy
| | - Rocchina Caivano
- U.O. Radioterapia Oncologica e Fisica Sanitaria, I.R.C.C.S. CROB, Rionero in Vulture (PZ), Italy
| | - Marco Carnì
- U.O.D. Fisica Sanitaria, A.O.U. Policlinico Umberto I, Roma, Italy
| | | | - Sara Cimolai
- U.O. Fisica Sanitaria, U.L.S.S. 2 Marca Trevigiana, Treviso, Italy
| | - Fabiola Cretti
- U.S.C. Fisica Sanitaria, A.O. Papa Giovanni XXIII, Bergamo, Italy
| | | | - Chiara Gasperi
- U.O.S.D. Fisica Sanitaria Arezzo, A.U.S.L. Toscana Sud Est, Arezzo, Italy
| | - Mara Giacometti
- S.O.D. Fisica Sanitaria, A.O.U. Ospedali Riuniti di Ancona, Ancona, Italy
| | - Fabrizio Levrero
- U.O. Fisica Sanitaria, Ospedale Policlinico San Martino, Genova, Italy
| | - Domenico Lizio
- Fisica Sanitaria, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Marta Maieron
- S.O.C. Fisica Sanitaria, A.S.U.I. Udine S. Maria della Misericordia, Udine, Italy
| | - Simona Marzi
- S.C. Laboratorio di Fisica Medica e Sistemi Esperti, Istituto Nazionale Tumori Regina Elena, Roma, Italy
| | - Lorella Mascaro
- U.O.C. Fisica Sanitaria, A.S.S.T. Spedali Civili, Brescia, Italy
| | - Silvia Mazzocchi
- S.C. Fisica Sanitaria Firenze-Empoli, A.U.S.L. Toscana Centro, Firenze, Italy
| | - Gabriele Meliadò
- U.O.C. Fisica Sanitaria, A.O.U. Integrata di Verona, Verona, Italy
| | | | - Alessandra Niespolo
- U.O.C. Fisica Sanitaria Area Nord, A.U.S.L. Toscana Nord Ovest, Lucca, Italy
| | | | - Nadia Oberhofer
- Servizio Aziendale di Fisica Sanitaria, A.S. dell'Alto Adige, Bolzano, Italy
| | - Laura Orsingher
- U.O. Fisica Sanitaria, U.L.S.S. 2 Marca Trevigiana, Treviso, Italy
| | | | | | - Alessandro Savini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Claudia Testa
- Dipartimento di Fisica e Astronomia, Università di Bologna, Bologna, Italy
| | - Paolo Tortoli
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy; Università degli Studi di Firenze, Firenze, Italy
| | - Gianni Gobbi
- Università degli Studi di Perugia, Perugia, Italy
| | - Cesare Gori
- Università degli Studi di Firenze, Firenze, Italy
| | - Luca Bernardi
- S.O.C. Fisica Sanitaria Pistoia-Prato, A.U.S.L. Toscana Centro, Italy
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy.
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Vallot D, De Ponti E, Morzenti S, Gramek A, Pieczonka A, Llompart GR, Siennicki J, Deak P, Dutta C, Uribe J, Caselles O. Evaluation of PET quantitation accuracy among multiple discovery IQ PET/CT systems via NEMA image quality test. EJNMMI Phys 2020; 7:30. [PMID: 32399647 PMCID: PMC7218035 DOI: 10.1186/s40658-020-00294-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/27/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction Quantitative imaging biomarkers are becoming usual in oncology for assessing therapy response. The harmonization of image quantitation reporting has become of utmost importance due to the multi-center trials increase. The NEMA image quality test is often considered for the evaluation of quantitation and is more accurate with a radioactive solid phantom that reduces variability. The goal of this project is to determine the level of variability among imaging centers if acquisition and imaging protocol parameters are left to the center’s preference while all other parameters are fixed including the scanner type. Methods A NEMA-IQ phantom filled with radioactive 68Ge solid resin was imaged in five clinical sites throughout Europe. Sites reconstructed data with OSEM and BSREM algorithms applying the sites’ clinical parameters. Images were analyzed according with the NEMA-NU2-2012 standard using the manufacturer-provided NEMA tools to calculate contrast recovery (CR) and background variability (BV) for each sphere and the lung error (LE) estimation. In addition, a 18F-filled NEMA-IQ phantom was also evaluated to obtain a gauge for variability among centers when the sites were provided with identical specific instructions for acquisition and reconstruction protocol (the aggregate of data from 12 additional sites is presented). Results The data using the 68Ge solid phantom showed no statistical differences among different sites, proving a very good reproducibility among the PET center models even if dispersion of data is higher with OSEM compared to BSREM. Furthermore, BSREM shows better CR and comparable BV, while LE is slightly reduced. Two centers exhibit significant differences in CR and BV values for the 18F NEMA NU2-2012 experiments; these outlier results are explained. Conclusion The same PET system type from the various sites produced similar quantitative results, despite allowing each site to choose their clinical protocols with no restriction on data acquisition and reconstruction parameters. BSREM leads to lower dispersion of quantitative data among different sites. A solid radioactive phantom may be recommended to qualify the sites to perform quantitative imaging.
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Affiliation(s)
- Delphine Vallot
- Medical Physics Department, Institut Claudius Regaud, Toulouse, France.
| | - Elena De Ponti
- Medical Physics Department, ASST-Monza, San Gerardo Hospital, Italy
| | - Sabrina Morzenti
- Medical Physics Department, ASST-Monza, San Gerardo Hospital, Italy
| | | | | | | | | | - Paul Deak
- General Electric Healthcare, Waukesha, USA
| | | | | | - Olivier Caselles
- Medical Physics Department, Institut Claudius Regaud, Toulouse, France
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Isella V, Rosazza C, Gazzotti M, Sala J, Morzenti S, Crivellaro C, Appollonio IM, Ferrarese C, Luzzatti C. A Metabolic Imaging Study of Lexical and Phonological Naming Errors in Alzheimer Disease. Am J Alzheimers Dis Other Demen 2020; 35:1533317520922390. [PMID: 32356456 PMCID: PMC10624092 DOI: 10.1177/1533317520922390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Patients with Alzheimer disease (AD) produce a variety of errors on confrontation naming that indicate multiple loci of impairment along the naming process in this disease. We correlated brain hypometabolism, measured with 18fluoro-deoxy-glucose positron emission tomography, with semantic and formal errors, as well as nonwords deriving from phonological errors produced in a picture-naming test by 63 patients with AD. Findings suggest that neurodegeneration leads to: (1) phonemic errors, by interfering with phonological short-term memory, or with control over retrieval of phonological or prearticulatory representations, within the left supramarginal gyrus; (2) semantic errors, by disrupting general semantic or visual-semantic representations at the level of the left posterior middle and inferior occipitotemporal cortex, respectively; (3) formal errors, by damaging the lexical-phonological output interface in the left mid-anterior segment of middle and superior temporal gyri. This topography of semantic-lexical-phonological steps of naming is in substantial agreement with dual-stream neurocognitive models of word generation.
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Affiliation(s)
- Valeria Isella
- Neurology Department, S. Gerardo Hospital, University of Milano–Bicocca, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | | | - Maria Gazzotti
- Department of Psychology, University of Milano–Bicocca, Monza, Italy
| | - Jessica Sala
- Department of Psychology, University of Milano–Bicocca, Monza, Italy
| | - Sabrina Morzenti
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Medical Physics, S. Gerardo Hospital, Monza, Italy
| | - Cinzia Crivellaro
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Nuclear Medicine, S. Gerardo Hospital, Monza, University of Milano–Bicocca, Italy
| | - Ildebrando Marco Appollonio
- Neurology Department, S. Gerardo Hospital, University of Milano–Bicocca, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Carlo Ferrarese
- Neurology Department, S. Gerardo Hospital, University of Milano–Bicocca, Monza, Italy
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
| | - Claudio Luzzatti
- Milan Center for Neuroscience (NeuroMI), Milan, Italy
- Department of Psychology, University of Milano–Bicocca, Monza, Italy
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Villa R, Paruccini N, Baglivi A, Signoriello M, Montezuma Velasquez RA, Morzenti S, De Ponti E, Crespi A. Model observers for Low Contrast Detectability evaluation in dynamic angiography: A feasible approach. Phys Med 2019; 64:89-97. [DOI: 10.1016/j.ejmp.2019.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 05/29/2019] [Accepted: 06/29/2019] [Indexed: 10/26/2022] Open
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Matheoud R, Bergesio F, Chiesa C, De Ponti E, Morzenti S, Ragazzoni M, Chauvie S. 80. Advancements in PET image reconstruction algorithms: Preliminary results of their application. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Coniglio A, Fedeli L, Belli G, Ciccarone A, Esposito M, Giannelli M, Gobbi G, Gori C, Mazzoni L, Nocetti L, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Betti M, Caivano R, Carnì M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Luchinat C, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Noferini L, Oberhofer N, Quattrocchi M, Ricci A, Taddeucci A, Tenori L, Torresin A, Busoni S. 20. Diffusion MRI and ADC accuracy at the isocenter: An AIFM multisite comparison study. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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18
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Fedeli L, Belli G, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Gobbi G, Gori C, Mazzoni L, Nocetti L, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Betti M, Caivano R, Carnì M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Luchinat C, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Noferini L, Oberhofer N, Quattrocchi M, Ricci A, Taddeucci A, Tenori L, Torresin A, Busoni S. 21 Phase encoding direction and position effects on ADC in diffusion MRI: An AFIM multisite comparison study. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Morzenti S, Spadavecchia C, Dolci C, De Ponti E, Guerra L, Landoni C, Crespi A. 83. Performance optimization using new PET/CT technology with respect to count statistic variation. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Spadavecchia C, De Ponti E, Morzenti S, Crespi A. 318. PET/CT image alignment: Methodology for assessment using a dedicated phantom. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.327] [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: 11/29/2022] Open
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De Ponti E, Morzenti S, Crivellaro C, Elisei F, Crespi A, Guerra L. Motion Management in PET/CT: Technological Solutions. Curr Radiopharm 2018; 11:79-85. [PMID: 29676240 DOI: 10.2174/1874471011666180419150440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/19/2018] [Accepted: 03/19/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Motion due to patient's breathing can introduce heavy bias in PET/CT, both in image quality and quantitation. This paper is a review of the main technical solutions available to manage movement in PET/CT studies: a) Respiratory Gated (RG), b) Motion Free (MF), c) End Expiration (EE), d) Banana Artefact Management (BAM) and e) Data Driven Gating (DDG). METHODS The most diffused solutions (RG, MF and EE) are based on LIST mode acquisition of a PET Field of View (4D FOV), centered on the anatomical region of interest; to link PET data not only to time and to spatial position but also to the corresponding breathing phase, the synchronized acquisition of the patient's breathing curve is performed by an external tracking device. Different commercial tools to track and to record patient breathing cycle are available to associate the internal organ motion with a measurable external parameter; for example these systems can measure the pressure on a chest elastic belt, the air flow trough patient nose, the breath-in and breath-out air temperature or the markers movement on the thorax/ abdominal region. Recently DDG techniques are developed to correct respiratory motion without the help of external motion tracking devices and to obtain a comparable result to that based on standard RG protocols. RESULTS The final result of an RG or DDG protocol is a sequence of 3D images showing organs and lesions movement; using the other motion management options a single 3D motion-free image is obtained without motion artefacts and degradation. Compared to the previously described options the BAM solution is not a real motion management protocol but just a Banana Artefact correction technique obtained using an Attenuation Correction Map calculated merging the Whole Body Helical CT with a Cine CT on the diaphragm area. CONCLUSION The motion management in PET/CT imaging shows benefits in terms of image quality, quantification and lesion detectability and it is useful both in diagnostic and radiotherapy planning.
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Affiliation(s)
- Elena De Ponti
- Medical Physics Department, San Gerardo Hospital, ASST-Monza, Italy
| | - Sabrina Morzenti
- Medical Physics Department, San Gerardo Hospital, ASST-Monza, Italy
| | - Cinzia Crivellaro
- Nuclear Medicine Department, San Gerardo Hospital, ASST-Monza, Italy.,University of Milano Bicocca, Milan, Italy
| | - Federica Elisei
- Nuclear Medicine Department, San Gerardo Hospital, ASST-Monza, Italy
| | - Andrea Crespi
- Medical Physics Department, San Gerardo Hospital, ASST-Monza, Italy
| | - Luca Guerra
- Nuclear Medicine Department, San Gerardo Hospital, ASST-Monza, Italy.,University of Milano Bicocca, Milan, Italy
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Fedeli L, Belli G, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Mazzoni LN, Nocetti L, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Betti M, Caivano R, Carni' M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliado' G, Morzenti S, Noferini L, Oberhofer N, Quattrocchi MG, Ricci A, Taddeucci A, Tenori L, Luchinat C, Gobbi G, Gori C, Busoni S. Dependence of apparent diffusion coefficient measurement on diffusion gradient direction and spatial position - A quality assurance intercomparison study of forty-four scanners for quantitative diffusion-weighted imaging. Phys Med 2018; 55:135-141. [PMID: 30342982 DOI: 10.1016/j.ejmp.2018.09.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/09/2018] [Accepted: 09/18/2018] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To propose an MRI quality assurance procedure that can be used for routine controls and multi-centre comparison of different MR-scanners for quantitative diffusion-weighted imaging (DWI). MATERIALS AND METHODS 44 MR-scanners with different field strengths (1 T, 1.5 T and 3 T) were included in the study. DWI acquisitions (b-value range 0-1000 s/mm2), with three different orthogonal diffusion gradient directions, were performed for each MR-scanner. All DWI acquisitions were performed by using a standard spherical plastic doped water phantom. Phantom solution ADC value and its dependence with temperature was measured using a DOSY sequence on a 600 MHz NMR spectrometer. Apparent diffusion coefficient (ADC) along each diffusion gradient direction and mean ADC were estimated, both at magnet isocentre and in six different position 50 mm away from isocentre, along positive and negative AP, RL and HF directions. RESULTS A good agreement was found between the nominal and measured mean ADC at isocentre: more than 90% of mean ADC measurements were within 5% from the nominal value, and the highest deviation was 11.3%. Away from isocentre, the effect of the diffusion gradient direction on ADC estimation was larger than 5% in 47% of included scanners and a spatial non uniformity larger than 5% was reported in 13% of centres. CONCLUSION ADC accuracy and spatial uniformity can vary appreciably depending on MR scanner model, sequence implementation (i.e. gradient diffusion direction) and hardware characteristics. The DWI quality assurance protocol proposed in this study can be employed in order to assess the accuracy and spatial uniformity of estimated ADC values, in single- as well as multi-centre studies.
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Affiliation(s)
- Luca Fedeli
- Università degli Studi di Firenze, Firenze, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marta Maieron
- A.S.U.I. Udine S. Maria della Misericordia, Udine, Italy
| | | | | | | | | | | | | | | | | | | | | | - Leonardo Tenori
- Magnetic Resonance Center (CERM), Università degli Studi di Firenze, Firenze, Italy
| | - Claudio Luchinat
- Magnetic Resonance Center (CERM), Università degli Studi di Firenze, Firenze, Italy
| | | | - Cesare Gori
- Università degli Studi di Firenze, Firenze, Italy
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Sghedoni R, Coniglio A, Mazzoni LN, Busoni S, Belli G, Tarducci R, Nocetti L, Fedeli L, Esposito M, Ciccarone A, Altabella L, Bellini A, Binotto L, Caivano R, Carnì M, Ricci A, Cimolai S, D'Urso D, Gasperi C, Levrero F, Mangili P, Morzenti S, Nitrosi A, Oberhofer N, Parruccini N, Toncelli A, Valastro LM, Gori C, Gobbi G, Giannelli M. A straightforward multiparametric quality control protocol for proton magnetic resonance spectroscopy: Validation and comparison of various 1.5 T and 3 T clinical scanner systems. Phys Med 2018; 54:49-55. [PMID: 30337010 DOI: 10.1016/j.ejmp.2018.08.013] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/25/2018] [Accepted: 08/13/2018] [Indexed: 02/08/2023] Open
Abstract
PURPOSE The aim of this study was to propose and validate across various clinical scanner systems a straightforward multiparametric quality assurance procedure for proton magnetic resonance spectroscopy (MRS). METHODS Eighteen clinical 1.5 T and 3 T scanner systems for MRS, from 16 centres and 3 different manufacturers, were enrolled in the study. A standard spherical water phantom was employed by all centres. The acquisition protocol included 3 sets of single (isotropic) voxel (size 20 mm) PRESS acquisitions with unsuppressed water signal and acquisition voxel position at isocenter as well as off-center, repeated 4/5 times within approximately 2 months. Water peak linewidth (LW) and area under the water peak (AP) were estimated. RESULTS LW values [mean (standard deviation)] were 1.4 (1.0) Hz and 0.8 (0.3) Hz for 3 T and 1.5 T scanners, respectively. The mean (standard deviation) (across all scanners) coefficient of variation of LW and AP for different spatial positions of acquisition voxel were 43% (20%) and 11% (11%), respectively. The mean (standard deviation) phantom T2values were 1145 (50) ms and 1010 (95) ms for 1.5 T and 3 T scanners, respectively. The mean (standard deviation) (across all scanners) coefficients of variation for repeated measurements of LW, AP and T2 were 25% (20%), 10% (14%) and 5% (2%), respectively. CONCLUSIONS We proposed a straightforward multiparametric and not time consuming quality control protocol for MRS, which can be included in routine and periodic quality assurance procedures. The protocol has been validated and proven to be feasible in a multicentre comparison study of a fairly large number of clinical 1.5 T and 3 T scanner systems.
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Affiliation(s)
| | - Angela Coniglio
- Medical Physics Unit, Ospedale San Giovanni Calibita Fatebenefratelli, Roma, Italy.
| | | | | | | | - Roberto Tarducci
- Health Physics Unit, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Luca Nocetti
- Health Physics Unit, Azienda Ospedaliera di Modena, Modena, Italy
| | - Luca Fedeli
- Physics and Astronomy Department, University of Florence, Firenze, Italy
| | - Marco Esposito
- Health Physics Unit, Azienda USL Toscana Centro, Firenze, Italy
| | | | | | | | - Luca Binotto
- Medical Physics Unit, Azienda ULSS 3 Serenissima, Mestre, Italy
| | - Rocchina Caivano
- Radiotherapy and Health Physics Unit, IRCCS CROB, Rionero in Vulture - Potenza, Italy
| | - Marco Carnì
- Health Physics Unit, Policlinico Umberto I, Roma, Italy
| | | | - Sara Cimolai
- Health Physics Unit, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy
| | - Davide D'Urso
- Health Physics Unit, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy
| | - Chiara Gasperi
- Health Physics Unit, Azienda USL Toscana Sud Est, Arezzo, Italy
| | - Fabrizio Levrero
- Medical and Health Physics Unit, IRCCS AOU San Martino, Genova, Italy
| | - Paola Mangili
- Medical Physics Unit, IRCCS San Raffaele, Milano, Italy
| | | | - Andrea Nitrosi
- Medical Physics Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Nadia Oberhofer
- Health Physics, Azienda Sanitaria della Provincia Autonoma di Bolzano, Bolzano, Italy
| | | | | | | | - Cesare Gori
- Health Physics Unit, AOU Careggi, Firenze, Italy
| | - Gianni Gobbi
- Health Physics Unit, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
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Isella V, Grisanti SG, Ferri F, Morzenti S, Crivellaro C, Musarra M, Ferrarese C. Cognitive reserve maps the core loci of neurodegeneration in corticobasal degeneration. Eur J Neurol 2018; 25:1333-1340. [PMID: 29931723 DOI: 10.1111/ene.13729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/19/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Cognitively stimulating life experiences and activities are deemed to moderate the clinical impact of brain damage progressively building a neural and cognitive reserve (CR). CR has been studied extensively in various neurodegenerative disorders, but not in corticobasal degeneration (CBD). METHODS Using Statistical Parametric Mapping 8, years of education, as a determinant of CR, was correlated with tracer uptake on positron emission tomography with 18 F-fluorodeoxyglucose, as a marker of neurodegeneration, in 35 patients with various phenotypes of CBD, including a cognitive-motor composite score or symptoms duration as covariates for controlling disease stage. RESULTS A cluster of relative hypometabolism was found associated with higher education in the left inferior regions of pre- and post-rolandic gyri and insula, which represent typical loci of neurodegeneration in CBD regardless of clinical presentation. CONCLUSIONS The present findings extend to CBD the evidence gathered in other neurodegenerative disorders that a higher CR has a protective effect against the clinical manifestations of brain degeneration.
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Affiliation(s)
- V Isella
- Department of Neurology, University of Milano Bicocca, Milan, Italy.,NeuroMI, Milan, Italy
| | - S G Grisanti
- Department of Neurology, University of Milano Bicocca, Milan, Italy
| | - F Ferri
- Department of Neurology, University of Milano Bicocca, Milan, Italy
| | - S Morzenti
- NeuroMI, Milan, Italy.,Department of Medical Physics, S. Gerardo Hospital, Monza, Italy
| | - C Crivellaro
- NeuroMI, Milan, Italy.,Nuclear Medicine Service, University of Milano Bicocca, Milan, Italy
| | - M Musarra
- NeuroMI, Milan, Italy.,Nuclear Medicine Service, University of Milano Bicocca, Milan, Italy
| | - C Ferrarese
- Department of Neurology, University of Milano Bicocca, Milan, Italy.,NeuroMI, Milan, Italy
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Guerra L, Ponti ED, Morzenti S, Spadavecchia C, Crivellaro C. Respiratory Motion Management in PET/CT: Applications and Clinical Usefulness. Curr Radiopharm 2018; 10:85-92. [PMID: 28530533 DOI: 10.2174/1874471010666170519165918] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Breathing movement can introduce heavy bias in both image quality and quantitation in PET/CT. The aim of this paper is a review of the literature to evaluate the benefit of respiratory gating in terms of image quality, quantification and lesion detectability. METHODS A review of the literature published in the last 10 years and dealing with gated PET/CT technique has been performed, focusing on improvement in quantification, lesion detectability and diagnostic accuracy in neoplastic lesion. In addition, the improvement in the definition of radiotherapy planning has been evaluated. RESULTS There is a consistent increase of the Standardized Uptake Value (SUV) in gated PET images when compared to ungated ones, particularly for lesions located in liver and in lung. Respiratory gating can also increase sensitivity, specificity and accuracy of PET/CT. Gated PET/CT can be used for radiation therapy planning, reducing the uncertainty in target definition, optimizing the volume to be treated and reducing the possibility of "missing" during the dose delivery. Moreover, new technologies, able to define the movement of lesions and organs directly from the PET sinogram, can solve some problems that currently are limiting the clinical use of gated PET/CT (i.e.: extended acquisition time, radiation exposure). CONCLUSION The published literature demonstrated that respiratory gating PET/CT is a valid technique to improve quantification, lesion detectability of lung and liver tumors and can better define the radiotherapy planning of moving lesions and organs. If new technical improvements for motion compensation will be clinically validated, gated technique could be applied routinely in any PET/CT scan.
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Affiliation(s)
- Luca Guerra
- Nuclear Medicine Department, San Gerardo Hospital - ASST Monza, University of Milano-Bicocca, Via Pergolesi 33, Monza, 20900. Italy
| | - Elena De Ponti
- Medical Physics Department, San Gerardo Hospital, ASST-Monza, Monza. Italy
| | - Sabrina Morzenti
- Medical Physics Department, San Gerardo Hospital, ASST-Monza, Monza. Italy
| | | | - Cinzia Crivellaro
- Nuclear Medicine Department, San Gerardo Hospital, ASST-Monza, Monza. Italy
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Rolandi E, Cavedo E, Pievani M, Galluzzi S, Ribaldi F, Buckley C, Cunningham C, Guerra UP, Musarra M, Morzenti S, Magnaldi S, Patassini M, Terragnoli F, Matascioli L, Franzoni S, Annoni G, Carnevali L, Bellelli G, Frisoni GB. Association of postoperative delirium with markers of neurodegeneration and brain amyloidosis: a pilot study. Neurobiol Aging 2018; 61:93-101. [DOI: 10.1016/j.neurobiolaging.2017.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/17/2017] [Accepted: 09/19/2017] [Indexed: 02/09/2023]
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Isella V, Falci I, Licciardo D, Urso P, Impagnatiello V, Crivellaro C, Morzenti S, Luzzatti C. Anatomical correlates of reading in the elderly brain: an FDG-PET analysis of the reading performance in Alzheimer's Disease. Front Hum Neurosci 2018. [DOI: 10.3389/conf.fnhum.2018.228.00053] [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: 11/13/2022] Open
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Crivellaro C, De Ponti E, Elisei F, Morzenti S, Picchio M, Bettinardi V, Versari A, Fioroni F, Dziuk M, Tkaczewski K, Ahond-Vionnet R, Nodari G, Todde S, Landoni C, Guerra L. Added diagnostic value of respiratory-gated 4D 18F-FDG PET/CT in the detection of liver lesions: a multicenter study. Eur J Nucl Med Mol Imaging 2017; 45:102-109. [PMID: 28825125 DOI: 10.1007/s00259-017-3795-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/26/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the added diagnostic value of respiratory-gated 4D18F-FDG PET/CT in liver lesion detection and characterization in a European multicenter retrospective study. METHODS Fifty-six oncological patients (29 males and 27 females, mean age, 61.2 ± 11.2 years) from five European centers, submitted to standard 3D-PET/CT and liver 4D-PET/CT were retrospectively evaluated. Based on visual analysis, liver PET/CT findings were scored as positive, negative, or equivocal both in 3D and 4D PET/CT. The impact of 4D-PET/CT on the confidence in classifying liver lesions was assessed. PET/CT findings were compared to histology and clinical follow-up as standard reference and diagnostic accuracy was calculated for both techniques. At semi-quantitative analysis, SUVmax was calculated for each detected lesion in 3D and 4D-PET/CT. RESULTS Overall, 72 liver lesions were considered for the analysis. Based on visual analysis in 3D-PET/CT, 32/72 (44.4%) lesions were considered positive, 21/72 (29.2%) negative, and 19/72 (26.4%) equivocal, while in 4D-PET/CT 48/72 (66.7%) lesions were defined positive, 23/72 (31.9%) negative, and 1/72 (1.4%) equivocal. 4D-PET/CT findings increased the confidence in lesion definition in 37/72 lesions (51.4%). Considering 3D equivocal lesions as positive, sensitivity, specificity, and accuracy were 88.9, 70.0, and 83.1%, respectively, while the same figures were 67.7, 90.0, and 73.8% if 3D equivocal findings were included as negative. 4D-PET/CT sensitivity, specificity, and accuracy were 97.8, 90.0, and 95.4%, respectively, considering equivocal lesions as positive and 95.6, 90.0, and 93.8% considering equivocal lesions as negative. The SUVmax of the liver lesions in 4D-PET (mean ± SD, 6.9 ± 3.2) was significantly higher (p < 0.001) than SUVmax in 3D-PET (mean ± SD, 5.2 ± 2.3). CONCLUSIONS Respiratory-gated PET/CT technique is a valuable clinical tool in diagnosing liver lesions, reducing 3D undetermined findings, improving diagnostic accuracy, and confidence in reporting. 4D-PET/CT also improved the quantification of SUVmax of liver lesions.
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Affiliation(s)
- Cinzia Crivellaro
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy. .,University of Milan-Bicocca, Milan, Italy.
| | | | | | | | - Maria Picchio
- Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Annibale Versari
- Nuclear Medicine, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | - Federica Fioroni
- Medical Physics, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | | | | | - Renée Ahond-Vionnet
- Service de Médecine Nucléaire, Hôpital Pierre Beregovoy, Cedex, Nevers, France
| | - Guillaume Nodari
- Service de Médecine Nucléaire, Hôpital Pierre Beregovoy, Cedex, Nevers, France
| | - Sergio Todde
- Tecnomed Foundation, University of Milan-Bicocca, Monza, Italy
| | - Claudio Landoni
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy.,University of Milan-Bicocca, Milan, Italy
| | - Luca Guerra
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy.,University of Milan-Bicocca, Milan, Italy
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Guglielmo P, Crivellaro C, Marzorati L, Patassini M, Morzenti S, Landoni C. 18 F-FDG-PET/CT guiding to diagnosis of neurosarcoidosis. Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2017.02.011] [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: 11/24/2022]
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Morzenti S, Zorz A, De Ponti E, Crespi A. A new regularized reconstruction algorithm in the evaluation of contrast detectability and background variability: Comparison with standard OSEM algorithm. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Zorz A, Morzenti S, Pizzichemi M, De Ponti E, Guerra L, Landoni C, De Bernardi E, Auffray E, Bugalho R, Da Silva J, Tavernier S, Varela J, Lecoq P, Paganoni M, Crespi A. Physical performance of ClearPEM, a dedicated scanner for positron emission mammography. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.398] [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: 11/29/2022] Open
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Sghedoni R, Coniglio A, Belli G, Busoni S, Ciccarone A, Esposito M, Giannelli M, Mazzoni L, Nocetti L, Tarducci R, Altabella I, Anoja R, Berardi P, Bertolini N, Biagini C, Carnì M, Cesana P, Cimolai S, Clemente S, Fabbri E, Fedeli L, Filice S, Levrero F, Meliadò G, Mordini N, Morzenti S, Moscato A, Oberhofer N, Paruccini N, Ricci A, Romeo N, Scelfo D, Toncelli A, Torresin A, Tosetti M, Zucca I, Gori C. AIFM multicenter intercomparison of MR scanners for proton spectroscopy – preliminary results. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.459] [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: 11/28/2022] Open
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Belli G, Busoni S, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Mazzoni LN, Nocetti L, Sghedoni R, Tarducci R, Zatelli G, Anoja RA, Belmonte G, Bertolino N, Betti M, Biagini C, Ciarmatori A, Cretti F, Fabbri E, Fedeli L, Filice S, Fulcheri CPL, Gasperi C, Mangili PA, Mazzocchi S, Meliadò G, Morzenti S, Noferini L, Oberhofer N, Orsingher L, Paruccini N, Princigalli G, Quattrocchi M, Rinaldi A, Scelfo D, Freixas GV, Tenori L, Zucca I, Luchinat C, Gori C, Gobbi G. Quality assurance multicenter comparison of different MR scanners for quantitative diffusion-weighted imaging. J Magn Reson Imaging 2015; 43:213-9. [PMID: 26013043 DOI: 10.1002/jmri.24956] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/11/2015] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To propose a magnetic resonance imaging (MRI) quality assurance procedure that can be used for multicenter comparison of different MR scanners for quantitative diffusion-weighted imaging (DWI). MATERIALS AND METHODS Twenty-six centers (35 MR scanners with field strengths: 1T, 1.5T, and 3T) were enrolled in the study. Two different DWI acquisition series (b-value ranges 0-1000 and 0-3000 s/mm(2) , respectively) were performed for each MR scanner. All DWI acquisitions were performed by using a cylindrical doped water phantom. Mean apparent diffusion coefficient (ADC) values as well as ADC values along each of the three main orthogonal directions of the diffusion gradients (x, y, and z) were calculated. Short-term repeatability of ADC measurement was evaluated for 26 MR scanners. RESULTS A good agreement was found between the nominal and measured mean ADC over all the centers. More than 80% of mean ADC measurements were within 5% from the nominal value, and the highest deviation and overall standard deviation were 9.3% and 3.5%, respectively. Short-term repeatability of ADC measurement was found <2.5% for all MR scanners. CONCLUSION A specific and widely accepted protocol for quality controls in DWI is still lacking. The DWI quality assurance protocol proposed in this study can be applied in order to assess the reliability of DWI-derived indices before tackling single- as well as multicenter studies.
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Affiliation(s)
| | | | | | - Angela Coniglio
- Medical Physics Department, Fondazione Fatebenefratelli per la Ricerca e la Formazione sanitaria e sociale, San Giovanni Calibita Hospital, Rome, Italy
| | | | | | | | - Luca Nocetti
- Medical Phisics Department, AOU Policlinico Modena, Italy
| | - Roberto Sghedoni
- Medical Physics Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | | | | | | | | | - Nicola Bertolino
- UO Direzione Sanitaria, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Margherita Betti
- Health Physics Unit, Centro Oncologico Fiorentino, Sesto Fiorentino, Italy
| | - Cristiano Biagini
- Radiodiagnostic Unit, Centro Oncologico Fiorentino, Sesto Fiorentino, Italy
| | | | | | - Emma Fabbri
- Health Physics Unit, Ospedale Sant'Orsola-Malpighi, Bologna, Italy
| | - Luca Fedeli
- Health Physics Unit, AOU Careggi, Florence, Italy
| | | | | | | | | | | | | | | | | | - Nadia Oberhofer
- Health Physics Unit, Azienda Sanitaria dell'Alto Adige-Ospedale Bolzano, Italy
| | - Laura Orsingher
- Medical Physics Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | | | | | | | - Adele Rinaldi
- Medical Physics Department, Fondazione Fatebenefratelli per la Ricerca e la Formazione sanitaria e sociale, San Giovanni Calibita Hospital, Rome, Italy
| | - Danilo Scelfo
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | | | - Leonardo Tenori
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy; FiorGen Foundation, Sesto Fiorentino, Italy
| | - Ileana Zucca
- UO Direzione Scientifica, IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Claudio Luchinat
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy; FiorGen Foundation, Sesto Fiorentino, Italy
| | - Cesare Gori
- Health Physics Unit, AOU Careggi, Florence, Italy
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Bomba M, Riva A, Morzenti S, Grimaldi M, Neri F, Nacinovich R. Global and regional brain volumes normalization in weight-recovered adolescents with anorexia nervosa: preliminary findings of a longitudinal voxel-based morphometry study. Neuropsychiatr Dis Treat 2015; 11:637-45. [PMID: 25834442 PMCID: PMC4358418 DOI: 10.2147/ndt.s73239] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The recent literature on anorexia nervosa (AN) suggests that functional and structural abnormalities of cortico-limbic areas might play a role in the evolution of the disease. We explored global and regional brain volumes in a cross-sectional and follow-up study on adolescents affected by AN. Eleven adolescents with AN underwent a voxel-based morphometry study at time of diagnosis and immediately after weight recovery. Data were compared to volumes carried out in eight healthy, age and sex matched controls. Subjects with AN showed increased cerebrospinal fluid volumes and decreased white and gray matter volumes, when compared to controls. Moreover, significant regional gray matter decrease in insular cortex and cerebellum was found at time of diagnosis. No regional white matter decrease was found between samples and controls. Correlations between psychological evaluation and insular volumes were explored. After weight recovery gray matter volumes normalized while reduced global white matter volumes persisted.
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Affiliation(s)
- Monica Bomba
- Child and Adolescent Mental Health Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Anna Riva
- Child and Adolescent Mental Health Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | | | - Marco Grimaldi
- Department of Radiology, Humanitas Research Hospital, Milan, Italy
| | - Francesca Neri
- Child and Adolescent Mental Health Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Renata Nacinovich
- Child and Adolescent Mental Health Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
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Brighina L, Saracchi E, Ferri F, Gagliardi M, Tarantino P, Morzenti S, Musarra M, Patassini M, Annesi G, Ferrarese C. Fahr's Disease Linked to a Novel SLC20A2 Gene Mutation Manifesting with Dynamic Aphasia. NEURODEGENER DIS 2014; 14:133-8. [DOI: 10.1159/000365216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 06/13/2014] [Indexed: 11/19/2022] Open
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Zoccarato O, Scabbio C, De Ponti E, Matheoud R, Leva L, Morzenti S, Menzaghi M, Campini R, Marcassa C, Del Sole A, Garancini S, Crivellaro C, Brambilla M, Lecchi M. Comparative analysis of iterative reconstruction algorithms with resolution recovery for cardiac SPECT studies. A multi-center phantom study. J Nucl Cardiol 2014; 21:135-48. [PMID: 24272971 DOI: 10.1007/s12350-013-9821-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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: 09/30/2013] [Accepted: 10/30/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND This investigation used image data generated by a physical phantom over a wide range of count statistics to evaluate the effectiveness of several of the newer commercially available SPECT reconstruction iterative algorithms (IRR) in improving perfusion defect contrast and spatial resolution, while controlling image noise. METHODS A cardiac phantom was imaged using four different gamma cameras over a wide range of counts statistics (from 6 to 0.8 Mcounts). Images were reconstructed with FBP, OSEM, and the IRR available on site. IRR were applied without corrections (IRR NC), with attenuation correction (IRR AC), scatter correction (IRR SC), and attenuation + scatter corrections (IRR SCAC). Four image performance indices related to spatial resolution, contrast, and image noise were analyzed. RESULTS IRR NC always determined significant improvements in all indices in comparison to FBP or OSEM. Improvements were emphasized with IRR SC and IRR SCAC. Count reduction from 6 to 1.5 Mcounts did not impair the performances of any of the considered indices. CONCLUSIONS This is the first study comparing the relative performance of different, commercially available, IRR software, over a wide range of count statistics; the additional effect of scatter and attenuation corrections, alone or in combination, was also evaluated. Our results confirm that IRR algorithms produce substantial benefits with respect to conventional FBP or OSEM reconstruction methods, as assessed through different figures of merit, in particular when SC and/or SCAC are also included.
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Affiliation(s)
- Orazio Zoccarato
- Department of Nuclear Medicine, S. Maugeri Foundation, IRCCS, Scientific Institute of Veruno, Veruno, NO, Italy
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Bomba M, Riva A, Veggo F, Grimaldi M, Morzenti S, Neri F, Nacinovich R. Impact of speed and magnitude of weight loss on the development of brain trophic changes in adolescents with anorexia nervosa: a case control study. Ital J Pediatr 2013; 39:14. [PMID: 23418915 PMCID: PMC3599113 DOI: 10.1186/1824-7288-39-14] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anorexia nervosa commonly arises during adolescence and is associated with more than one medical morbidity. Abnormalities in brain structure (defined as "pseudoatrophy") are common in adolescents with anorexia nervosa; however, their correlations with endocrinological profiles and clinical parameters are still unclear. In particular, no study has described the impact of BMI (body mass index) variations (speed and magnitude of weight loss) on cerebral trophism changes. METHODS Eleven adolescents with anorexia nervosa and 8 healthy controls underwent cerebral MRI (magnetic resonance imaging) examination to obtain global and partial volumes (gray matter, white matter and cerebrospinal fluid) and clinical evaluation. The Mann-Whitney U test was used to compare partial volumes and clinical variables between cases and controls. The Spearman non-parametric test was performed in order to explore correlations between the variables studied. RESULTS The patients diagnosed with AN showed significantly increased cerebrospinal fluid (CSF) volumes and decreased total gray (GM) and white matter (WM) volumes. The degree of weight loss (deltaBMI) correlated inversely with the GM volume; the increase of CSF compartment correlated directly with the rapidity of weight loss (DeltaBMI/disease duration). CONCLUSIONS This study suggests a correlation between cerebral alterations in AN and the speed and magnitude of weight loss, and outlines its importance for the therapeutic treatment.
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Affiliation(s)
- Monica Bomba
- Department of Child and Adolescent Psychiatry, San Gerardo Hospital, Monza, Italy.
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Arosio M, Pasquali C, Crivellaro C, De Ponti E, Morzenti S, Guerra L, Crespi A, Messa C. Performance of a SPECT collimator-detector response reconstruction algorithm: phantom studies and validation in inflammation clinical studies. Q J Nucl Med Mol Imaging 2011; 55:671-679. [PMID: 21285924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM To evaluate evolution for bone (EfB), one of the recent corrective collimator detector response (CDR) image reconstruction packages, resolution recovery and iterative reconstruction protocols were compared to the standard Filtered Back Projection (FBP) protocol and the possibility of time reduced acquisition (15 instead of 30 seconds/projection) was evaluated. METHODS Tomographic spatial resolution, contrast, noise and signal-to-noise ratio (SNR) were analyzed in phantom studies. Patient studies were conducted on sixteen [99mTc]HMPAO labeled leukocyte patients with suspected local inflammation, submitted to SPECT/CT and conventional leukocyte scintigraphy. Target background ratio (TBR) and boundary of each lesion were calculated. Images were also analyzed by visual inspection by two blinded expert physicians. RESULTS a) Phantom: resolution in phantom improves with the use of EfB mainly due to iterative reconstruction methods vs FBP. EfB shows a reduction in noise. No differences were found in contrast data, while SNR changes were mainly due to changes in noise. Time reduction, while increasing image noise, does not modify resolution; nevertheless, half-time EfB noise is the same as full-time FBP noise. b) PATIENTS lesion boundary is better defined in patient studies using iterative reconstruction vs FBP; no changes were observed for CDR vs iterative OSEM, or for full-time vs half-time acquisition. TBR is comparable in iterative and FBP protocols, while it is improved by EfB. At visual inspection, a higher score is always associated with EfB. CONCLUSION Resolution, noise, SNR and TBR improve when applying the resolution recovery. EfB permits reduction of acquisition time without compromising image quality.
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Affiliation(s)
- M Arosio
- Nuclear Medicine Unit, San Gerardo Hospital of Monza, Monza, Italy.
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De Ponti E, Morzenti S, Guerra L, Pasquali C, Arosio M, Bettinardi V, Crespi A, Gilardi MC, Messa C. Performance measurements for the PET/CT Discovery-600 using NEMA NU 2-2007 standards. Med Phys 2011; 38:968-74. [DOI: 10.1118/1.3544655] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Morzenti S, Bonardi ML, Groppi F, Zona C, Persico E, Menapace E, Alfassi ZB. Cyclotron production of 211At/211gPo by 209Bi(α,2n) reaction. J Radioanal Nucl Chem 2008. [DOI: 10.1007/s10967-008-0642-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Groppi F, Bonardi ML, Birattari C, Menapace E, Abbas K, Holzwarth U, Alfarano A, Morzenti S, Zona C, Alfassi ZB. Optimisation study of α-cyclotron production of At-211/Po-211g for high-LET metabolic radiotherapy purposes. Appl Radiat Isot 2005; 63:621-31. [PMID: 16055338 DOI: 10.1016/j.apradiso.2005.05.041] [Citation(s) in RCA: 33] [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: 11/20/2022]
Abstract
The production of no-carrier-added (NCA) alpha-emitter (211)At/(211g)Po radionuclides for high-LET targeted radiotherapy and immunoradiotherapy, through the (209)Bi(alpha,2n) reaction, together with the required wet radiochemistry and radioanalytical quality controls carried out at LASA is described, through dedicated irradiation experiments at the MC-40 cyclotron of JRC-Ispra. The amount of both the gamma-emitter (210)At and its long half-lived alpha-emitting daughter (210)Po is optimised and minimised by appropriate choice of energy and energy loss of alpha particle beam. The measured excitation functions for production of the main radioisotopic impurity (210)At-->(210)Po are compared with theoretical predictions from model calculations performed at ENEA.
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Affiliation(s)
- F Groppi
- Università degli Studi di Milano and INFN-Milano, LASA, Radiochemistry Laboratory, via F.lli Cervi 201, I-20090 Segrate, Milan, Italy.
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Bagatti D, Cantone MC, Giussani A, Ridone S, Birattari C, Bonardi ML, Groppi F, Martinotti A, Morzenti S, Gallorini M, Rizzio E. Analytical and radioanalytical quality control of purity and stability of radiopharmaceutical compound [ 186gRe]Re-HEDP for bone metastases pain palliation. J Radioanal Nucl Chem 2005. [DOI: 10.1007/s10967-005-0085-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Albonico C, Morzenti S, Giani L, Samiotakis E. [Unusual finding of ectopic pancreatic tissue as cause of intermittent pyloric occlusion]. MINERVA CHIR 1986; 41:1449-53. [PMID: 3785701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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