Andrea Romano

Andrea Romano
Sant´Andrea Hospital · Neuroradiology

MD

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106
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Publications

Publications (106)
Article
Background: Non-echo planar (EPI) diffusion-weighted (DW) MRI has become an effective tool for the follow-up after cholesteatoma surgery and decreased the rate of second-look surgeries. Objectives: To shed light on the optimal imaging follow-up protocol to detect postoperative residual or recurrent cholesteatoma. Materials and methods: 64 pati...
Article
Asterion is an uncommon site for lesions, especially dermoid cysts. We report a case series of three asterional intracranial dermoid cysts, which, to the best of our knowledge, have never been described before. Patients presented with non-specific symptoms and underwent surgical excision of the lesions. It is crucial to correctly diagnose intracran...
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Purpose The authors’ purpose was to create a valid multiparametric MRI model for the differential diagnosis between glioblastoma and solitary brain metastasis. Materials and methods Forty-one patients (twenty glioblastomas and twenty-one brain metastases) were retrospectively evaluated. MRIs were analyzed with Olea Sphere ® 3.0. Lesions’ volumes o...
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When the language-dominant hemisphere is damaged by a focal lesion, the brain may reorganize the language network through functional and structural changes known as adaptive plasticity. Adaptive plasticity is documented for triggers including ischemic, tumoral, and epileptic focal lesions, with effects in clinical practice. Many questions remain re...
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Cerebral venous sinus thrombosis (CVST) on non-contrast CT (NCCT) is often challenging to detect. We retrospectively selected 41 children and 36 adults with confirmed CVST and two age-matched control groups with comparable initial symptoms. We evaluated NCCT placing four small circular ROIs in standardized regions of the cerebral dural venous syste...
Article
Background Treatment-resistance in schizophrenia is 30–40%. Its neurobiology remains unclear; to explore it, we conducted a combined spectrometry/tractography/cognitive battery and psychopathological rating study on patients with treatment-resistant schizophrenia (TRS), dividing the sample into early-onset (N = 21) and adult-onset TRS (N = 20). Pre...
Article
Objectives : The aim of this study is to evaluate the role of preoperative ischemic brain lesion (IBL) volume, assessed by Diffusion-weighted magnetic resonance brain imaging (DW-MRI) with RAPID® processing, and surgery timing in predicting post-operative neurological outcomes in symptomatic carotid stenosis (SCS) patients treated with carotid enda...
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Objective Middle ear cholesteatoma may lead to the erosion of the bony structures of the temporal bone, possibly causing intra- and extracranial complications. Surgical treatment is mandatory, and due to possible residual/recurrent disease, the use of reliable diagnostic methods is essential. Our study aimed to evaluate the reliability of non-EPI D...
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Radiomic models outperform clinical data for outcome prediction in high-grade gliomas (HGG). However, lack of parameter standardization limits clinical applications. Many machine learning (ML) radiomic models employ single classifiers rather than ensemble learning, which is known to boost performance, and comparative analyses are lacking in the lit...
Article
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system (CNS), clinically defined by an acute polyfocal neurological syndrome usually with monophasic course. ADEM often occurs after infections, but 5%–10% of cases are preceded by vaccinations. Several cases of ADEM have been described after...
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Background and Purpose Glioblastoma (GBM) is an aggressive primary CNS neoplasm with poor overall survival (OS) despite standard of care. On MRI, GBM is usually characterized by an enhancing portion (CET) (surgery target) and a nonenhancing surrounding (NET). Extent of resection is a long debated issue in GBM, with recent evidence suggesting that b...
Preprint
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PURPOSEThe authors purpose was to evaluate ADC and rCBV values in the enhanced lesion, in the peritumoral area and in distal oedema using a Volume of Interest (VOI) based method and to analysed hemodynamic curves obtained from DSC perfusion MRI, in order to create a valid multiparametric MRI model for the differential diagnosis between Glioblastoma...
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Isocitrate dehydrogenase (IDH) mutant and wildtype glioblastoma multiforme (GBM) often show overlapping features on magnetic resonance imaging (MRI), representing a diagnostic challenge. Deep learning showed promising results for IDH identification in mixed low/high grade glioma populations; however, a GBM-specific model is still lacking in the lit...
Preprint
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Background: Distinction of IDH mutant and wildtype GBMs is challenging on MRI, since conventional imaging shows considerable overlap. While few studies employed deep-learning in a mixed low/high grade glioma population, a GBM-specific model is still lacking in the literature. Our objective was to develop a deep-learning model for IDH prediction in...
Preprint
Full-text available
Radiomic models have been shown to outperform clinical data for outcome prediction in glioblastoma (GBM). However, clinical implementation is limited by lack of parameters standardization. We aimed to compare nine machine learning classifiers, with different optimization parameters, to predict overall survival (OS), isocitrate dehydrogenase (IDH) m...
Article
Hemorrhage into a juxtafacet cyst is rare and cyst rupture with hemorrhagic extension into the epidural space is even less commonly seen. We describe the case of a patient with a hemorrhagic synovial cyst with rupture associated to abundant bleeding in the epidural space. A 61-year-old man had a 5-month history of worsening low back pain radiating...
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Non-congenital viral infections of the central nervous system in children can represent a severe clinical condition that needs a prompt diagnosis and management. However, the aetiological diagnosis can be challenging because symptoms are often nonspecific and cerebrospinal fluid analysis is not always diagnostic. In this context, neuroimaging repre...
Article
Background The evolution of radiation necrosis (RN) varies depending on the combination of radionecrotic tissue and active tumor cells. In this study, we characterized the long-term metabolic evolution of RN by sequential PET/CT imaging with 3,4‑dihydroxy‑6‑[ 18F]‑fluoro-l‑phenylalanine (F-DOPA) in patients with brain metastases following stereotac...
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Purpose: Kearns Sayre syndrome (KSS) is a mitochondrial disorder characterized by development of visual impairment. Electroretinogram (ERG) and visual evoked potentials are not able to provide topographical information of optic damage. The purpose of this study was to explore retrochiasmatic optic pathway alteration in KSS with diffusion tractogra...
Article
Background and purpose The aim of the present prospective study was to verify the specificity of non-EPI DWI-MRI in patients operated for middle ear CHO who showed positivity at imaging performed 6 to 9 months after surgery and underwent second-look surgery. Materials and methods All patients underwent 1.5-T non-EPI DWI-MRI 6 to 9 months after sur...
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Background: Magnetic resonance imaging (MRI) is largely used in the diagnosis of central nervous system involvement of tuberculosis (CNSTB), yet there is no MRI comparison study between HIV+ and HIV- patients with CNSTB. The aim of the present study was to identify MRI differences in CNSTB between HIV+ and HIV- patients and possibly find early cha...
Article
Purpose: to investigate clinical outcomes in patients with large brain metastases from non-small-cell lung cancer (NSCLC) who received surgical resection and postoperative stereotactic radiosurgery or SRS alone. Patients and methods: Two hundred and twenty-two patients with 241 large brain metastases (2-4 cm in size) who received surgery and mul...
Article
Background and Purpose This study was aimed to investigate the role of dynamic TurboFLASH gadolinium (Gd) magnetic resonance (MR) imaging in improving the differential diagnosis of skull base tumors. Methods Eleven patients with skull base tumors underwent standard MR and ultrafast TurboFLASH sequence during gadolinium injection. Results The charac...
Chapter
In 2016 the World Health Organization released an update of the classification of brain tumors, based on the increased understanding, over the past two decades, of the genetic basis of tumorigenesis. The new classification, for the first time, integrated both genotypic and phenotypic parameters, leading to a molecular stratification of brain tumors...
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Purpose Cognitive decline in Down syndrome generally shows neurodegenerative aspects similar to what is observed in Alzheimer’s disease. Few studies reported information on white matter integrity. The aim of this study was to evaluate white matter alterations in a cohort of young Down subjects, without dementia, by means of DTI technique, compared...
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Purpose: The identification of prognostic biomarkers plays a pivotal role in the management of glioblastoma. The aim of this study was to assess the role of magnetic resonance dynamic susceptibility contrast imaging (DSC-MRI) with histogram analysis in the prognostic evaluation of patients suffering from glioblastoma. Materials and methods: Sixt...
Article
The Garcin syndrome is a rare condition characterized by multiple unilateral cranial nerve palsy, without neither long-tract involvement nor intracranial hypertension. Non-Hodgkin lymphoma is a systemic malignant disease that localizes in a minority of cases in the central nervous system. We report a case of Garcin syndrome that revealed a diffuse...
Article
The name of the last author (as shown in the author listing on page 229) was incorrectly tagged during the journal production process, and so appears incorrectly in the PubMed record. The name should be indexed in PubMed as.
Article
In recent years, gadolinium-based contrast agents have been associated with different types of toxicity. In particular, nephrogenic systemic fibrosis, a progressive sclerotic-myxedematous systemic disease of unknown etiology, is related to gadolinium-based contrast agent administration in patients with kidney dysfunction. More recently, evidence of...
Article
Background & objective: Brain areas of functional activation during emotional stimuli and their correlations with affective temperaments evaluated using Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A) and hopelessness levels assessed with the Beck Hopelessness Scale (BHS) have been investigated. Method: Brain activity in r...
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PurposeOur hypothesis was that pituitary macroadenomas show different areas of consistency detectable by enhanced magnetic resonance imaging (MRI) with Dynamic study during gadolinium administration. Materials and methodsWe analysed 21 patients with pituitary macroadenomas between June 2013 and June 2015. All patients underwent trans-sphenoidal sur...
Article
We describe the use of time-resolved MR angiography in the diagnosis of cervical epidural arteriovenous fistula before final diagnosis and embolization was achieved by digital subtraction angiography. A 42-year-old woman was referred to us because of headache and dizziness, in addition to radiculopathy of the right superior limb. Angiographic exami...
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Objective: To compare MRI using perfusion and diffusion techniques with 6-[(18)F]-fluoro-L-3,4-dihydroxyphenylalanine ((18)F-FDOPA) positron emission tomography (PET) in the follow-up of low-grade gliomas (LGGs) and to identify the best imaging parameter to differentiate patients with different prognosis. Methods: Between 2010 and 2015, 12 patie...
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Protocols for Application of Non-EPI DW MRI in Cholesteatoma - Volume 130 Issue S3 - Maurizio Barbara, Alessandro Bozzao, Edoardo Covelli, Andrea Romano, Luigi Volpini, Veronica Confaloni
Article
Purpose: To investigate the local control and radiation-induced brain necrosis in patients with brain metastases >2 cm in size who received single-fraction or multifraction stereotactic radiosurgery (SRS); factors associated with clinical outcomes and the development of brain radionecrosis were assessed. Methods and materials: Two hundred eighty...
Chapter
Acute neurological symptoms in pregnant and postpartum women could be caused by worsening of preexisting neurological conditions (multiple sclerosis or a seizure disorders) or by an initial presentation of a nonpregnancy-related problem (brain neoplasm). Patients can present with new acute-onset neurological conditions that are common during or aft...
Article
In the present study we have evaluated the efficacy and toxicity of repeated stereotactic radiosurgery (SRS) in patients with recurrent/progressive brain metastases. Between March 2006 and October 2014, 43 patients (21 men and 22 women) with 47 lesions received a second course of SRS given in three daily fractions of 7-8 Gy. With a follow-up study...
Article
BACKGROUND AND PURPOSEThe aim of this study was to investigate the characteristic pattern of age-related cortical thinning in patients with Down Syndrome (DS), as assessed by MRI and automatic cortical thickness measurements.METHODS Ninety-one non-demented subjects with DS (range 11–53 years) were examined using a 1.5 T scanner. MRI-based quantific...
Article
We report a woman with malignant meningioma diagnosed 9years after the treatment of a choroidal melanoma with proton beam therapy. The risk of secondary cancers is a well-known adverse late effect of radiation therapy, especially with the use of advanced techniques such as intensity-modulated radiation therapy. However, this risk may be less with t...
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We report a case of neurosyphilis presenting with meningitis and subacute multicranial neuropathy in a young immune-competent man. Signs of primary and secondary stages of syphilitic infection occurred almost contemporarily in our patient. MRI revealed the involvement of several cranial nerves. CSF examination proved to be diagnostic. Syphilitic me...
Article
Introduction: The aim of this study was to determine differences in the characteristic pattern of age-related cortical thinning in men and women with Down's syndrome (DS) by means of MRI and automatic cortical thickness measurements and a cross-sectional design, in a large cohort of young subjects. Methods: Eighty-four subjects with DS, 30 femal...
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Objectives: In this preliminary report, we describe our experience with time-resolved imaging of contrast kinetics-MR angiography (TRICKS-MRA) in the assessment of head-neck vascular anomalies (HNVAs). Methods: We prospectively studied six consecutive patients with clinically suspected or diagnosed HNVAs. All of them underwent TRICKS-MRA of the...
Article
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Pituitary apoplexy (PA) is a rare and potentially fatal clinical condition presenting acute headache, vomiting, visual impairment, ophthalmoplegia, altered mental state and possible panhypopituitarism. It mostly occurs in patients with haemorrhagic infarction of the pituitary gland due to a pre-existing macroadenoma. Although there are pathological...
Article
Objective: To assess what kind of information MR examination in flexed and extended positions provides in Down syndrome subjects with suspected cranio-cervical instability. Methods: Between 2005 and 2008, 35 subjects with DS were recruited in the study. Ethics committee approval was granted and a signed informed consent was obtained from the par...
Article
To compare intraoperative dynamic contrast-enhanced (dCE) sequences with conventional CE (cCE) in the evaluation of the surgical bed after transsphenoidal removal of pituitary macroadenomas. Twenty-one patients with macroadenoma were selected. They all underwent intraoperative magnetic resonance imaging (iMRI) (1.5T) acquisitions during transspheno...
Article
The identification of diffuse axonal injury (DAI) can be difficult, especially using conventional imaging (CT or MRI), which usually appears normal. Diffusion tensor imaging (DTI) is useful in identifying white matter abnormalities in patients with DAI. We describe the case of a 17-year-old female with severe closed head injury and right-side hemip...
Article
Purpose: The aim of this study was to verify the sensitivity and specificity of the hyperdense middle cerebral artery sign (HMCAS) obtained by multidetector computed tomography (CT) in predicting acute stroke, using diffusion-weighted (DW) magnetic resonance imaging (MRI) as a reference. The location of the HMCAS, the extension of the ischaemic le...
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Purpose: We assessed the performance of 6-[(18)F]-fluoro-L-3,4-dihydroxyphenylalanine (F-DOPA) PET for differentiating radionecrosis (RN) from tumour progression (PD) in a population of patients with brain metastases, treated with stereotactic radiosurgery. The accuracy of F-DOPA PET was compared with that of perfusion-weighted magnetic resonance...
Article
Though classical trigeminal neuralgia (CTN) is frequently caused by neurovascular contact (NVC) at the trigeminal root entry zone (REZ), both anatomical and MRI studies have shown that NVC of the trigeminal nerve frequently occurs in people without CTN. To assess the accuracy of MRI in distinguishing symptomatic from asymptomatic trigeminal NVC, we...
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A second course of whole brain radiation therapy (WBRT) has been employed in selected patients with progressive brain metastases providing favorable symptomatic palliation with acceptable toxicity, although its efficacy and safety remain matter of debate. In the present study we have evaluated the outcomes in patients with progressive intracranial...
Conference Paper
PURPOSE The usually scheduled treatment in patient affected by glioblastoma multiforme (GBM) is surgery followed by radiotherapy (RT) associated with temozolamide (TMZ) chemotherapy. Possible findings during early (within 4 months) follow-up MRI are new enhancing lesions either due to recurrence or to early radiation necrosis (the so called pseudo-...
Conference Paper
PURPOSE The status of MGMT promoter methylation in glioblastomas (GBM) currently is obtained after surgery since considered a prognostic marker of the disease and more frequently related to pseudo-progression. The purpose of this study was to evaluate whether apparent diffusion coefficient (ADC) values can predict the status of MGMT of GBM and corr...
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White matter hyperintensities (WMH) have been associated with mood disorders in psychiatric patients. In the present study, we aimed to assess whether WMHs are associated with depressive symptoms and different sensitivity of the behavioral inhibition (BIS), and activation (BAS) systems in patients with chronic headache. Participants were 85 adult o...
Article
Objective: To evaluate whether apparent diffusion coefficient (ADC) values can predict the status of MGMT of glioblastoma multiforme (GBM) and correlate with overall survival (OS) and progression-free survival (PFS). Methods: This retrospective study included 47 patients with pathologically proven glioblastoma. All of them underwent MR DWI study...
Article
Angiolipomas are benign mesenchymal tumors infrequently affecting the head and neck region, manifesting themselves as small (<4 cm), slow-growing mass that are painful or tender to palpation. Ultrasonography, fine needle aspiration biopsy, computed tomography, and magnetic resonance imaging can be used to make a diagnosis. Surgical excision is the...
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We report our preliminary series of patients treated for lesions involving the motor cortex and the corticospinal tract in BrainSuite, with intraoperative MRI, tractography and “neuronavigated” electrophysiological cortical and subcortical mapping. An exact localization of the cortical and subcortical functional areas is mandatory for executing sur...
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CADASIL is a hereditary disease characterized by cerebral subcortical microangiopathy leading to early onset cerebral strokes and progressive severe cognitive impairment. Until now, only few studies have investigated the extent and localization of grey matter (GM) involvement. The purpose of our study was to evaluate GM volume alterations in CADASI...
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Inflammatory pseudotumour (IPT) is an uncommon disease with undefined pathogenesis. It is often characterized by local aggressiveness with compressive and displacing effects on surrounding structures. It may appear in different regions of the body, rarely involving perineural structures unilaterally. We present a case of a bilateral IPT around trig...
Article
Magnetic resonance imaging (MRI) with a dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) sequence to study brain tumours provides information on the haemodynamic characteristics of the neoplastic tissue. Brain perfusion maps and calculation of perfusion parameters, such as relative cerebral blood flow (rCBF), relative cerebral b...
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to investigate the factors affecting survival and toxicity in patients treated with stereotactic radiosurgery (SRS), with special attention to volumes of brain receiving a specific dose (V10 - V16 Gy) as predictors for brain radionecrosis. Two hundred six consecutive patients with 310 cerebral metastases less than 3.5 cm were treated with SRS as pr...