Publications by authors named "Anzalone N"
Vascular inflammation is widely recognized as an important factor in the atherosclerotic process, particularly in terms of plaque development and progression. Conventional tests, such as measuring circulating inflammatory biomarkers, lack the precision to identify specific areas of vascular inflammation. In this context, noninvasive imaging modalities can detect perivascular fat changes, serving as a marker of vascular inflammation.
View Article and Find Full Text PDFEarly diagnosis is crucial for the successful treatment of primary CNS lymphoma (PCNSL), a rapidly progressing tumour. Suspicion raised on brain MRI must be confirmed by a histopathological diagnosis of a tumour specimen collected by stereotactic biopsy. In rare cases, cerebrospinal fluid (CSF) or vitreous humour might aid in providing a cytological diagnosis.
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- This multicentric study investigated neuroradiological findings in COVID-19 patients during the early pandemic in Italy, focusing on data collected from May to June 2020 at two hospitals.
- A total of 415 patients were enrolled, with notable findings including ischemic stroke (29.4% of patients) and a variety of non-stroke neuroimaging lesions like PRES-like syndrome and encephalitis.
- The study concluded that COVID-19 patients are at increased risk of strokes due to a pro-thrombotic environment, reinforcing findings observed globally regarding brain imaging in infected patients.
Background: To describe high-resolution brain vessel wall MRI (VW-MRI) patterns and morphological brain findings in central nervous system (CNS) vasculitis patients.
Methods: Fourteen patients with confirmed CNS Vasculitis from two tertiary centers underwent VW-MRI using a 3T scanner. The images were reviewed by two neuroradiologists to assess vessel wall enhancement characteristics and locations.
Purpose: Vessel wall imaging (VWI) with black-blood (BB) technique can demonstrate aneurysmal enhancement preluding to growth/rupture in treatment-naive cerebral aneurysms. Interestingly, recent works showed that BB enhancement may also occur in endovascularly treated aneurysms, though its meaning is controversial. Hypothesizing a flow-related mechanism of BB enhancement, we explored its relationship with incomplete occlusion status and coil packing density at DSA.
View Article and Find Full Text PDFPurpose: Primary central nervous system lymphoma (PCNSL) is a rare, aggressive form of extranodal non-Hodgkin lymphoma. To predict the overall survival (OS) in advance is of utmost importance as it has the potential to aid clinical decision-making. Though radiomics-based machine learning (ML) has demonstrated the promising performance in PCNSL, it demands large amounts of manual feature extraction efforts from magnetic resonance images beforehand.
View Article and Find Full Text PDFIntroduction: The differential diagnosis of brain diseases becomes challenging in cases where imaging is not sufficiently informative, and surgical biopsy is impossible or unacceptable to the patient.
Methods: An elderly patient with progressive short-term memory loss and cognitive impairment presented with a normal brain CT scan, a brain FDG-PET that indicated symmetrical deterioration of the white matter in the frontal lobes, and inconclusive results of a molecular marker analysis of suspected dementia in cerebrospinal fluid (CSF). Brain MRI suggested the diagnosis of lower grade glioma.
Article Synopsis
- Primary Central Nervous System Lymphoma (PCNSL) is a serious brain cancer that often shows poor response to standard chemotherapy, highlighting the need for better predictive models for patient outcomes.
- This study analyzed radiomics features from MRI scans of 80 PCNSL patients to develop machine learning models aimed at predicting overall survival (OS) and progression-free survival (PFS).
- Results indicated that using radiomics features from normalized MRI images led to a significant improvement in prediction accuracy for both OS (23% better) and PFS (50% better) compared to traditional clinical methods, suggesting a new avenue for enhancing treatment strategies in PCNSL.
We report an uncommon, infratentorial localization of adult H3 K27M-altered diffuse midline glioma arising in a particularly rare site (medulla oblongata). In addition to this unusual presentation, the lesion exhibited a substantial contrast enhancement and size decrease after dexamethasone, generating diagnostic dilemmas. Histology, molecular details, advanced Magnetic Resonance imaging features and differential diagnoses are here described and discussed, as well as common misconceptions about steroid-sensitive mass lesions, and practical difficulties for clinicians involved in the process of making diagnosis.
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- CE-MRI is the preferred imaging method for diagnosing and monitoring primary central nervous system lymphoma, but it may not accurately reflect the true tumor size due to its reliance on specific anatomical measurements.
- While standard T1 and T2 MRI techniques are commonly used, incorporating additional methods like diffusion-weighted and perfusion-weighted imaging could enhance understanding of tumor behavior and response to treatment.
- There is a pressing need for standardizing imaging practices and reporting, as current inconsistencies hinder effective treatment planning and clinical trial outcomes for patients with PCNSL.
Article Synopsis
- Tumor heterogeneity in high-grade gliomas (HGGs) presents significant clinical issues, but a new quantitative radiomic analysis using spatial tumor habitat clustering shows promise for understanding this complexity in a non-invasive way.
- This study assesses an integrated approach using PET and MRI to evaluate tumor hypoxia, perfusion, and diffusion, creating a combined map for identifying intra-tumor heterogeneity in HGGs.
- Results indicate that the spatial distribution of tumor habitats corresponds well with key morphological features and histopathological characteristics, suggesting this method enhances conventional imaging with useful insights into tumor microenvironments.
Objectives: To investigate the clinical meaning of brain parenchymal computed-tomography hyperdensities (CTHD) in patients treated of anterior circulation acute stroke with reperfusion therapy.
Methods: Patients were retrospectively enrolled from three different hospitals. Brain CT scans were assessed at four time points: We recorded ASPECT scores of pre-treatment CTs, assessed ASPECT scores and the presence of CTHD on post-treatment CTs acquired within 24-30 h and 24-72 h, and examined a one-month CTs follow-up to determine the ischemic evolution of CTHD.
Background: Vascular lesions may be a common finding also in Alzheimer's dementia, but their role on cognitive status is uncertain.
Objective: The study aims to investigate their distribution in patients with Alzheimer's, vascular or mixed dementia and detect any distinctive neuroradiological profiles.
Methods: Seventy-six subjects received a diagnosis of Alzheimer's (AD=32), vascular (VD=26) and mixed (MD=18) dementia.
Purpose: Patients with steno-occlusive arterial disease may develop cerebral hypoperfusion with possible neurologic sequelae. The aim of the study is to verify the possible role of SWI, as a marker of cerebral hypoperfusion, in the identification of patient subgroups with significant chronic occlusions/stenoses at risk of critical cerebral hypoperfusion.
Methods: We retrospectively identified 37 asymptomatic patients with chronic intra-extracranial occlusion/stenosis of the anterior circulation from a prospective brain MRI register between 2016 and 2020.
Neurological and neuroradiological manifestations in patients with COVID-19 have been extensively reported. Available imaging data are, however, very heterogeneous. Hence, there is a growing need to standardise clinical indications for neuroimaging, MRI acquisition protocols, and necessity of follow-up examinations.
View Article and Find Full Text PDFIntroduction: The modern treatment of patients with primary central nervous system lymphoma (PCNSL) consists of two phases: induction, currently represented by a high-dose-methotrexate-based polychemotherapy, and consolidation. The optimal consolidation therapy has not been defined yet, but several strategies, such as whole-brain radiotherapy (WBRT), high-dose chemotherapy supported by autologous stem cell transplantation (HDC/ASCT) or nonmyeloablative chemotherapy, have been addressed in important randomized trials.
Areas Covered: This review provides an overview of the current role of consolidation strategies in young and fit patients with newly diagnosed PCNSL.
Objective: To investigate the role of quantitative muscle biomarkers assessed with skeletal muscle index at the third lumbar vertebra (L3-SMI) and temporal muscle thickness (TMT) in predicting progression-free and overall survival in patients with primary central nervous system lymphoma (PCNSL) undergoing first-line high-dose methotrexate-based chemotherapy.
Methods: L3-SMI and TMT were calculated on abdominal CT and brain high-resolution 3D-T1-weighted MR images, respectively, using predefined validated methods. Standardized sex-specific cut-off values were used to divide patients in different risk categories.
Background: Contrast-enhanced magnetic resonance angiography (CE-MRA) has become a very popular imaging technique in the evaluation of the extracranial vessels pathology, while it is not commonly used to rule out intracranial vascular pathology. On the contrary, 3D time of flight MRA (TOF-MRA) has a solid role in the study of intracranial arterial vessels disease.
Materials And Methods: One hundred and eight patients were consecutively included in the study.
Background: To investigate the correlation between 18F-labeled fluoroazomycinarabinoside (18F-FAZA) PET data and hypoxia immunohistochemical markers in patients with high-grade glioma (HGG).
Patients And Methods: Prospective study including 20 patients with brain MRI suggestive for HGG and undergoing 18F-FAZA PET/CT before treatment for hypoxia assessment. For each 18F-FAZA PET scan SUVmax, SUVmean and 18F-FAZA tumour volume (FTV) at 40, 50 and 60% threshold of SUVmax were calculated; hypoxic volume was estimated by applying different thresholds (1.