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  1. Article ; Online: A hybrid machine learning/deep learning COVID-19 severity predictive model from CT images and clinical data.

    Chieregato, Matteo / Frangiamore, Fabio / Morassi, Mauro / Baresi, Claudia / Nici, Stefania / Bassetti, Chiara / Bnà, Claudio / Galelli, Marco

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 4329

    Abstract: COVID-19 clinical presentation and prognosis are highly variable, ranging from asymptomatic and paucisymptomatic cases to acute respiratory distress syndrome and multi-organ involvement. We developed a hybrid machine learning/deep learning model to ... ...

    Abstract COVID-19 clinical presentation and prognosis are highly variable, ranging from asymptomatic and paucisymptomatic cases to acute respiratory distress syndrome and multi-organ involvement. We developed a hybrid machine learning/deep learning model to classify patients in two outcome categories, non-ICU and ICU (intensive care admission or death), using 558 patients admitted in a northern Italy hospital in February/May of 2020. A fully 3D patient-level CNN classifier on baseline CT images is used as feature extractor. Features extracted, alongside with laboratory and clinical data, are fed for selection in a Boruta algorithm with SHAP game theoretical values. A classifier is built on the reduced feature space using CatBoost gradient boosting algorithm and reaching a probabilistic AUC of 0.949 on holdout test set. The model aims to provide clinical decision support to medical doctors, with the probability score of belonging to an outcome class and with case-based SHAP interpretation of features importance.
    MeSH term(s) Algorithms ; COVID-19/diagnostic imaging ; Deep Learning ; Humans ; Machine Learning ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2022-03-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-07890-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: SARS-CoV-2-related encephalitis with prominent parkinsonism: clinical and FDG-PET correlates in two patients.

    Morassi, Mauro / Palmerini, Francesco / Nici, Stefania / Magni, Eugenio / Savelli, Giordano / Guerra, Ugo Paolo / Chieregato, Matteo / Morbelli, Silvia / Vogrig, Alberto

    Journal of neurology

    2021  Volume 268, Issue 11, Page(s) 3980–3987

    Abstract: Considering the similarities with other pandemics due to respiratory virus infections and subsequent development of neurological disorders (e.g. encephalitis lethargica after the 1918 influenza), there is growing concern about a possible new wave of ... ...

    Abstract Considering the similarities with other pandemics due to respiratory virus infections and subsequent development of neurological disorders (e.g. encephalitis lethargica after the 1918 influenza), there is growing concern about a possible new wave of neurological complications following the worldwide spread of SARS-CoV-2. However, data on COVID-19-related encephalitis and movement disorders are still limited. Herein, we describe the clinical and neuroimaging (FDG-PET/CT, MRI and DaT-SPECT) findings of two patients with COVID-19-related encephalopathy who developed prominent parkinsonism. None of the patients had previous history of parkinsonian signs/symptoms, and none had prodromal features of Parkinson's disease (hyposmia or RBD). Both developed a rapidly progressive form of atypical parkinsonism along with distinctive features suggestive of encephalitis. A possible immune-mediated etiology was suggested in Patient 2 by the presence of CSF-restricted oligoclonal bands, but none of the patients responded favorably to immunotherapy. Interestingly, FDG-PET/CT findings were similar in both cases and reminiscent of those observed in post-encephalitic parkinsonism, with cortical hypo-metabolism associated with hyper-metabolism in the brainstem, mesial temporal lobes, and basal ganglia. Patient's FDG-PET/CT findings were validated by performing a Statistical Parametric Mapping analysis and comparing the results with a cohort of healthy controls (n = 48). Cerebrum cortical thickness map was obtained in Patient 1 from MRI examinations to evaluate the structural correlates of the metabolic alterations detected with FDG-PET/CT. Hypermetabolic areas correlated with brain regions showing increased cortical thickness, suggesting their involvement during the inflammatory process. Overall, these observations suggest that SARS-CoV-2 infection may trigger an encephalitis with prominent parkinsonism and distinctive brain metabolic alterations.
    MeSH term(s) COVID-19 ; Encephalitis ; Fluorodeoxyglucose F18 ; Humans ; Parkinsonian Disorders/diagnostic imaging ; Parkinsonian Disorders/etiology ; Positron Emission Tomography Computed Tomography ; SARS-CoV-2
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2021-04-21
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 187050-6
    ISSN 1432-1459 ; 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    ISSN (online) 1432-1459
    ISSN 0340-5354 ; 0012-1037 ; 0939-1517 ; 1619-800X
    DOI 10.1007/s00415-021-10560-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Book ; Online: A hybrid machine learning/deep learning COVID-19 severity predictive model from CT images and clinical data

    Chieregato, Matteo / Frangiamore, Fabio / Morassi, Mauro / Baresi, Claudia / Nici, Stefania / Bassetti, Chiara / Bnà, Claudio / Galelli, Marco

    2021  

    Abstract: COVID-19 clinical presentation and prognosis are highly variable, ranging from asymptomatic and paucisymptomatic cases to acute respiratory distress syndrome and multi-organ involvement. We developed a hybrid machine learning/deep learning model to ... ...

    Abstract COVID-19 clinical presentation and prognosis are highly variable, ranging from asymptomatic and paucisymptomatic cases to acute respiratory distress syndrome and multi-organ involvement. We developed a hybrid machine learning/deep learning model to classify patients in two outcome categories, non-ICU and ICU (intensive care admission or death), using 558 patients admitted in a northern Italy hospital in February/May of 2020. A fully 3D patient-level CNN classifier on baseline CT images is used as feature extractor. Features extracted, alongside with laboratory and clinical data, are fed for selection in a Boruta algorithm with SHAP game theoretical values. A classifier is built on the reduced feature space using CatBoost gradient boosting algorithm and reaching a probabilistic AUC of 0.949 on holdout test set. The model aims to provide clinical decision support to medical doctors, with the probability score of belonging to an outcome class and with case-based SHAP interpretation of features importance.

    Comment: 16 pages, 10 figures, 2 supplementary tables
    Keywords Quantitative Biology - Quantitative Methods ; Computer Science - Computer Vision and Pattern Recognition ; Computer Science - Machine Learning ; Electrical Engineering and Systems Science - Image and Video Processing ; Physics - Medical Physics
    Subject code 006
    Publishing date 2021-05-13
    Publishing country us
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Impact of inter-observer variability on first axillary level dosimetry in breast cancer radiotherapy: An AIRO multi-institutional study.

    Leonardi, Maria Cristina / Pepa, Matteo / Zaffaroni, Mattia / Vincini, Maria Giulia / Luraschi, Rosa / Vigorito, Sabrina / Morra, Anna / Dicuonzo, Samantha / Mazzola, Giovanni Carlo / Gerardi, Marianna Alessandra / Zerella, Maria Alessia / Cante, Domenico / Petrucci, Edoardo / Borzì, Giuseppina / Marrocco, Maristella / Chieregato, Matteo / Iadanza, Luciano / Lobefalo, Francesca / Valenti, Marco /
    Cavallo, Anna / Russo, Serenella / Guernieri, Marika / Malatesta, Tiziana / Meaglia, Ilaria / Liotta, Marco / Palumbo, Isabella / Marcantonini, Marta / Mezzenga, Emilio / Falivene, Sara / Arrichiello, Cecilia / Barbero, Maria Paola / Ivaldi, Giovanni Battista / Catalano, Gianpiero / Vidali, Cristiana / Giannitto, Caterina / Ciabattoni, Antonella / Meattini, Icro / Aristei, Cynthia / Orecchia, Roberto / Cattani, Federica / Jereczek-Fossa, Barbara Alicja

    Tumori

    2023  Volume 109, Issue 6, Page(s) 570–575

    Abstract: This study quantified the incidental dose to the first axillary level (L1) in locoregional treatment plan for breast cancer. Eighteen radiotherapy centres contoured L1-L4 on three different patients (P1,2,3), created the L2-L4 planning target volume ( ... ...

    Abstract This study quantified the incidental dose to the first axillary level (L1) in locoregional treatment plan for breast cancer. Eighteen radiotherapy centres contoured L1-L4 on three different patients (P1,2,3), created the L2-L4 planning target volume (single centre planning target volume, SC-PTV) and elaborated a locoregional treatment plan. The L2-L4 gold standard clinical target volume (CTV) along with the gold standard L1 contour (GS-L1) were created by an expert consensus. The SC-PTV was then replaced by the GS-PTV and the incidental dose to GS-L1 was measured. Dosimetric data were analysed with Kruskal-Wallis test. Plans were intensity modulated radiotherapy (IMRT)-based. P3 with 90° arm setup had statistically significant higher L1 dose across the board than P1 and P2, with the mean dose (Dmean) reaching clinical significance. Dmean of P1 and P2 was consistent with the literature (77.4% and 74.7%, respectively). The incidental dose depended mostly on L1 proportion included in the breast fields, underlining the importance of the setup, even in case of IMRT.
    MeSH term(s) Humans ; Female ; Breast Neoplasms/radiotherapy ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy Dosage ; Observer Variation ; Breast ; Radiotherapy, Intensity-Modulated
    Language English
    Publishing date 2023-09-09
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 280962-x
    ISSN 2038-2529 ; 0300-8916
    ISSN (online) 2038-2529
    ISSN 0300-8916
    DOI 10.1177/03008916231196801
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: IQ SPECT allows a significant reduction in administered dose and acquisition time for myocardial perfusion imaging: evidence from a phantom study.

    Caobelli, Federico / Kaiser, Stefano Ren / Thackeray, James T / Bengel, Frank M / Chieregato, Matteo / Soffientini, Alberto / Pizzocaro, Claudio / Savelli, Giordano / Galelli, Marco / Guerra, Ugo Paolo

    Journal of nuclear medicine : official publication, Society of Nuclear Medicine

    2014  Volume 55, Issue 12, Page(s) 2064–2070

    Abstract: Unlabelled: We recently demonstrated in a clinical trial the ability of a new protocol, IQ SPECT, to acquire myocardial perfusion imaging (MPI) studies in a quarter of the time (12 s/view) of the standard protocol, with preserved diagnostic accuracy. We ...

    Abstract Unlabelled: We recently demonstrated in a clinical trial the ability of a new protocol, IQ SPECT, to acquire myocardial perfusion imaging (MPI) studies in a quarter of the time (12 s/view) of the standard protocol, with preserved diagnostic accuracy. We now aim to establish the lower limit of radioactivity that can be administered to patients and the minimum acquisition time in SPECT MPI using an IQ SPECT protocol, while preserving diagnostic accuracy.
    Methods: An anthropomorphic cardiac phantom was used to acquire clinical rest scans with a simulated in vivo distribution of (99m)Tc-tetrofosmin at full dose (740 MBq) and at doses equal to 50%, 25%, and 18%. For each dose, 2 sets of images were acquired, with and without a transmural defect (TD). Variable acquisition times were also used for each dose. We analyzed raw data and reconstructed images, including no correction and correction for attenuation (AC), for scatter (SC), or for both (ACSC). Images were evaluated qualitatively and quantitatively in order to assess left ventricle (LV) wall thickness (full width at half maximum of the medial sections), TD, and cavity contrast in the LV wall. Data were compared across different acquisition times within the same dose and across doses with the same acquisition time.
    Results: Images were visually scored as very-good quality except those acquired with 4 s/view or less at 100% dose and 6 s/view or less with 50%, 25%, or 18% dose, due to false-positive defects. LV wall thickness was not significantly different among all acquisitions. Cavity contrast remained unchanged within the same dose for all images and tended to be higher in AC and ACSC images. TD contrast remained unchanged within the same dose for all images. In SC and no-correction images, contrast was constant for all doses. AC images had significantly higher TD contrast values, and ACSC images showed a drop in TD contrast for a 50% dose.
    Conclusion: IQ SPECT effectively preserved both image quality and quantitative measurements with reduced acquisition time or administered dose in a phantom study. These findings suggest that approximately one eighth of the time, compared with standard protocols with a full dose, or a lower dose at an acquisition time of 12 s/view can be applied in MPI without the loss of diagnostic accuracy.
    MeSH term(s) Algorithms ; Coronary Circulation/physiology ; Heart/diagnostic imaging ; Humans ; Image Processing, Computer-Assisted/methods ; Myocardial Perfusion Imaging/methods ; Phantoms, Imaging ; Radiopharmaceuticals/administration & dosage ; Tomography, Emission-Computed, Single-Photon/methods
    Chemical Substances Radiopharmaceuticals
    Language English
    Publishing date 2014-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80272-4
    ISSN 1535-5667 ; 0097-9058 ; 0161-5505 ; 0022-3123
    ISSN (online) 1535-5667
    ISSN 0097-9058 ; 0161-5505 ; 0022-3123
    DOI 10.2967/jnumed.114.143560
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The importance of a correct positioning of the heart using IQ-SPECT system with multifocal collimators in myocardial perfusion imaging: a phantom study.

    Caobelli, Federico / Ren Kaiser, Stefano / Thackeray, James Thomas / Bengel, Frank Michael / Chieregato, Matteo / Soffientini, Alberto / Pizzocaro, Claudio / Savelli, Giordano / Guerra, Ugo Paolo / Galelli, Marco / Zoccarato, Orazio

    Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

    2014  Volume 22, Issue 1, Page(s) 57–65

    Abstract: Background: We have recently validated a quarter-time protocol in Myocardial Perfusion Imaging named IQ-SPECT, whose basic principle is to implement a multifocal collimator; However, in clinical practice, it may sometimes be difficult to center the ... ...

    Abstract Background: We have recently validated a quarter-time protocol in Myocardial Perfusion Imaging named IQ-SPECT, whose basic principle is to implement a multifocal collimator; However, in clinical practice, it may sometimes be difficult to center the heart in the region of highest magnification of the multifocal collimators (the so-called sweet spot). We therefore aimed to evaluate whether a heart mispositioning may affect results in MPI.
    Methods: We simulated a rest study with an anthropomorphic phantom with an in vivo distribution of 400 MBq [(99m)Tc]tetrofosmin, with and without a transmural defect (TD). For each set of images, we performed 5 acquisitions, one with a correct centering and with other 4 degrees of mispositioning. Raw data and reconstructed images were evaluated qualitatively and quantitatively, including no corrections, correction for attenuation, for scatter or for both. We assessed polar plot uniformity, LV wall thickness, and TD and cavity contrast.
    Results: Images obtained either with a correct heart centering or with mild misposition showed no differences, both qualitatively and quantitatively. Those obtained with major mispositioning differed in uniformity and TD contrast depending on correction parameters.
    Conclusion: This is the first study investigating how a heart mispositioning can affect diagnostic accuracy with IQ-SPECT system. Mild-to-moderate mispositioning (≤2.5 cm) is unlikely to significantly affect results.
    MeSH term(s) Anthropometry ; Heart/diagnostic imaging ; Heart Ventricles/pathology ; Humans ; Image Processing, Computer-Assisted ; Motion ; Myocardial Perfusion Imaging ; Organophosphorus Compounds ; Organotechnetium Compounds ; Patient Positioning ; Phantoms, Imaging ; Radiopharmaceuticals ; Reproducibility of Results ; Software ; Tomography, Emission-Computed, Single-Photon
    Chemical Substances Organophosphorus Compounds ; Organotechnetium Compounds ; Radiopharmaceuticals ; technetium tc-99m tetrofosmin (42FOP1YX93)
    Language English
    Publishing date 2014-10-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1212505-2
    ISSN 1532-6551 ; 1071-3581
    ISSN (online) 1532-6551
    ISSN 1071-3581
    DOI 10.1007/s12350-014-9994-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Geometric contour variation in clinical target volume of axillary lymph nodes in breast cancer radiotherapy: an AIRO multi-institutional study.

    Leonardi, Maria Cristina / Pepa, Matteo / Gugliandolo, Simone Giovanni / Luraschi, Rosa / Vigorito, Sabrina / Rojas, Damaris Patricia / La Porta, Maria Rosa / Cante, Domenico / Petrucci, Edoardo / Marino, Lorenza / Borzì, Giuseppina / Ippolito, Edy / Marrocco, Maristella / Huscher, Alessandra / Chieregato, Matteo / Argenone, Angela / Iadanza, Luciano / De Rose, Fiorenza / Lobefalo, Francesca /
    Cucciarelli, Francesca / Valenti, Marco / De Santis, Maria Carmen / Cavallo, Anna / Rossi, Francesca / Russo, Serenella / Prisco, Agnese / Guernieri, Marika / Guarnaccia, Roberta / Malatesta, Tiziana / Meaglia, Ilaria / Liotta, Marco / Tabarelli de Fatis, Paola / Palumbo, Isabella / Marcantonini, Marta / Colangione, Sarah Pia / Mezzenga, Emilio / Falivene, Sara / Mormile, Maria / Ravo, Vincenzo / Arrichiello, Cecilia / Fozza, Alessandra / Barbero, Maria Paola / Ivaldi, Giovanni Battista / Catalano, Gianpiero / Vidali, Cristiana / Aristei, Cynthia / Giannitto, Caterina / Miglietta, Eleonora / Ciabattoni, Antonella / Meattini, Icro / Orecchia, Roberto / Cattani, Federica / Jereczek-Fossa, Barbara Alicja

    The British journal of radiology

    2021  Volume 94, Issue 1123, Page(s) 20201177

    Abstract: Objectives: To determine interobserver variability in axillary nodal contouring in breast cancer (BC) radiotherapy (RT) by comparing the clinical target volume of participating single centres (SC-CTV) with a gold-standard CTV (GS-CTV).: Methods: The ... ...

    Abstract Objectives: To determine interobserver variability in axillary nodal contouring in breast cancer (BC) radiotherapy (RT) by comparing the clinical target volume of participating single centres (SC-CTV) with a gold-standard CTV (GS-CTV).
    Methods: The GS-CTV of three patients (P1, P2, P3) with increasing complexity was created in DICOM format from the median contour of axillary CTVs drawn by BC experts, validated using the simultaneous truth and performance-level estimation and peer-reviewed. GS-CTVs were compared with the correspondent SC-CTVs drawn by radiation oncologists, using validated metrics and a total score (TS) integrating all of them.
    Results: Eighteen RT centres participated in the study. Comparative analyses revealed that, on average, the SC-CTVs were smaller than GS-CTV for P1 and P2 (by -29.25% and -27.83%, respectively) and larger for P3 (by +12.53%). The mean Jaccard index was greater for P1 and P2 compared to P3, but the overlap extent value was around 0.50 or less. Regarding nodal levels, L4 showed the highest concordance with the GS. In the intra-patient comparison, L2 and L3 achieved lower TS than L4. Nodal levels showed discrepancy with GS, which was not statistically significant for P1, and negligible for P2, while P3 had the worst agreement. DICE similarity coefficient did not exceed the minimum threshold for agreement of 0.70 in all the measurements.
    Conclusions: Substantial differences were observed between SC- and GS-CTV, especially for P3 with altered arm setup. L2 and L3 were the most critical levels. The study highlighted these key points to address.
    Advances in knowledge: The present study compares, by means of validated geometric indexes, manual segmentations of axillary lymph nodes in breast cancer from different observers and different institutions made on radiotherapy planning CT images. Assessing such variability is of paramount importance, as geometric uncertainties might lead to incorrect dosimetry and compromise oncological outcome.
    MeSH term(s) Axilla ; Breast Neoplasms/pathology ; Breast Neoplasms/radiotherapy ; Female ; Humans ; Italy ; Lymphatic Metastasis/pathology ; Lymphatic Metastasis/radiotherapy ; Observer Variation ; Radiotherapy Planning, Computer-Assisted/methods
    Language English
    Publishing date 2021-04-21
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2982-8
    ISSN 1748-880X ; 0007-1285
    ISSN (online) 1748-880X
    ISSN 0007-1285
    DOI 10.1259/bjr.20201177
    Database MEDical Literature Analysis and Retrieval System OnLINE

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