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Book: Neuroradiology of Brain Tumors

Triulzi, Fabio Maria

Practical Guide based on the 5th Edition of WHO Classification

2023

Author's details	Dr. Triulzi began his career as a neuroradiologist more than 30 years ago, just at the onset of the technological evolution in the field brought about by the introduction of MR imaging. He had the opportunity to spend his training years in the largest and most technologically advanced Italian private teaching hospital, the San Raffaele Scientific Institute in Milan. Since the end of the '80s his professional interest has focused on Pediatric Neuroradiology. During his early tenure at San Raffaele Scientific Institute he started a clinical and research program on newborns; the program quickly grew to cover other clinical areas of pediatric neuroradiology. This pioneering activity led to Dr. Triulzi's appointment as Director of Pediatric Radiology and Neuroradiology at Milan's Children's Hospital "Vittore Buzzi" in 2000. In 2012 he was appointed Director of the Neuroradiological Unit at the IRCCS Cà Granda Foundation University Hospital in Milan, the hospital with the largest fetal-ma
Keywords	Neuro-Oncology ; imaging ; Cancer ; PediatricNeurology ; neuropathology ; WHObraintumorsclassification ; Neuro-oncology ; Imaging ; Pediatric Neurology ; Neuropathology ; WHO brain tumors classification
Language	English
Size	260 p.
Edition	1
Publisher	Springer International Publishing
Document type	Book
Note	PDA Manuell_24
Format	183 x 260 x 19
ISBN	9783031381522 ; 3031381521
Database	PDA

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Article: Incidence of intra-procedural complications according to the timing of endovascular treatment in ruptured intracranial aneurysms.

Gaudino, Chiara / Navone, Stefania Elena / Da Ros, Valerio / Guarnaccia, Laura / Marfia, Giovanni / Pantano, Patrizia / Peschillo, Simone / Triulzi, Fabio Maria / Biraschi, Francesco

Frontiers in neurology

2023 Volume 13, Page(s) 1096651

Abstract: Background: Although endovascular treatment of ruptured intracranial aneurysms is well-established, some critical issues have not yet been clarified, such as the effects of timing on safety and effectiveness of the procedure. The aim of our study was to ...

Abstract	Background: Although endovascular treatment of ruptured intracranial aneurysms is well-established, some critical issues have not yet been clarified, such as the effects of timing on safety and effectiveness of the procedure. The aim of our study was to analyze the incidence of intra-procedural complications according to the timing of treatment, as they can affect morbidity and mortality. Materials and methods: We retrospectively analyzed all patients who underwent endovascular treatment for ruptured intracranial aneurysms at three high flow center. For all patients, imaging and clinical data, aneurysm's type, mean dimension and different treatment techniques were analyzed. Intra-procedural complications were defined as thrombus formation at the aneurysm's neck, thromboembolic events, and rupture of the aneurysm. Patients were divided into three groups according to time between subarachnoid hemorrhage and treatment (<12 h hyper-early, 12-36 h early, and >36 h delayed). Results: The final study population included 215 patients. In total, 84 patients (39%) underwent hyper-early, 104 (48%) early, and 27 (13%) delayed endovascular treatment. Overall, 69% of the patients were treated with simple coiling, 23% with balloon-assisted coiling, 1% with stent-assisted coiling, 3% with a flow-diverter stent, 3% with an intrasaccular flow disruptor device, and 0.5% with parent vessel occlusion. Delayed endovascular treatment was associated with an increased risk of total intra-procedural complications compared to both hyper-early ( Conclusions: Endovascular treatment of ruptured intracranial aneurysms more than 36 h after SAH seems to be associated with a higher risk of intra-procedural complications, especially thrombotic and thromboembolic events.
Language	English
Publishing date	2023-01-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.1096651
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Article ; Online: Diabetic ketoacidosis with central nervous system involvement: Conventional and advanced magnetic resonance neuroimaging findings.

Caschera, Luca / Fiore, Giorgio / Nava, Simone / Criscuolo, Stefania / Lo Russo, Francesco M / Casale, Silvia / Conte, Giorgio / Platania, Giulia / Costa, Antonella / Carrabba, Giorgio / Locatelli, Marco / Triulzi, Fabio Maria

The neuroradiology journal

2024 , Page(s) 19714009241248745

Abstract: Diabetic ketoacidosis (DKA) is a serious complication in children with diabetes mellitus type 1 (DM1). In rare and severe cases DKA may be complicated by cerebral edema, central brain herniation and cerebral infarctions. We present the magnetic resonance ...

Abstract	Diabetic ketoacidosis (DKA) is a serious complication in children with diabetes mellitus type 1 (DM1). In rare and severe cases DKA may be complicated by cerebral edema, central brain herniation and cerebral infarctions. We present the magnetic resonance imaging findings in a child with DKA and central nervous system involvement; diffusion tensor imaging (DTI) and functional MRI (fMRI) were performed to assess the white matter integrity of sensory pathways and cortical sensory processing. Conventional imaging showed bilateral uncal herniation, effacement of the perimesencephalic cisterns, wide ischemic lesions in the posterior cerebral artery (PCA) territories, sagging brainstem and Duret's hemorrhage consistent with signs of central brain herniation and intracranial hypertension. Advanced MRI showed a possible left-sided cortical reorganization for sensory function, with underlying left cortico-talamic and cortico-spinal pathways less severely impaired. Knowledge of the full framework in these conditions is of vital importance for timely patient management; advanced neuroimaging techniques may be considered as prognostic indicators in those cases with extensive involvement of eloquent brain areas.
Language	English
Publishing date	2024-04-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2257770-1
ISSN	2385-1996 ; 1971-4009 ; 1120-9976
ISSN (online)	2385-1996
ISSN	1971-4009 ; 1120-9976
DOI	10.1177/19714009241248745
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Article ; Online: Disorders of Ventral Induction/Spectrum of Holoprosencephaly.

Calloni, Sonia Francesca / Caschera, Luca / Triulzi, Fabio Maria

Neuroimaging clinics of North America

2019 Volume 29, Issue 3, Page(s) 411–421

Abstract: Disorders of the ventral induction give rise to a group of congenital malformations that share in common the failure of the prosencephalon cleavage and subsequent formation of midline structures, presenting with a wide spectrum of severity. This article ... ...

Abstract	Disorders of the ventral induction give rise to a group of congenital malformations that share in common the failure of the prosencephalon cleavage and subsequent formation of midline structures, presenting with a wide spectrum of severity. This article focuses on the imaging findings of the holoprosencephaly spectrum and septo-optic dysplasia, their epidemiology, embryology, and the common clinical associated anomalies. Knowledge of the imaging features of these disorders is necessary for a correct interpretation of findings and accurate parental counseling. Diagnostic evaluation of patients should include molecular screening and genetic counseling to characterize prognosis and risk of recurrence.
MeSH term(s)	Brain/abnormalities ; Brain/diagnostic imaging ; Holoprosencephaly/diagnostic imaging ; Humans ; Magnetic Resonance Imaging/methods
Language	English
Publishing date	2019-04-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1314594-0
ISSN	1557-9867 ; 1052-5149
ISSN (online)	1557-9867
ISSN	1052-5149
DOI	10.1016/j.nic.2019.03.003
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Article ; Online: Amyotrophic lateral sclerosis with upper motor neuron predominance: diagnostic accuracy of qualitative and quantitative susceptibility metrics in the precentral gyrus.

Lo Russo, Francesco / Contarino, Valeria Elisa / Conte, Giorgio / Morelli, Claudia / Trogu, Francesca / Casale, Silvia / Sbaraini, Sara / Caschera, Luca / Genovese, Valentina / Liu, Chunlei / Cinnante, Claudia Maria / Silani, Vincenzo / Triulzi, Fabio Maria

European radiology

2023 Volume 33, Issue 11, Page(s) 7677–7685

Abstract: Objective: The study aims at comparing the diagnostic accuracy of qualitative and quantitative assessment of the susceptibility in the precentral gyrus in detecting amyotrophic lateral sclerosis (ALS) with predominance of upper motor neuron (UMN) ... ...

Abstract	Objective: The study aims at comparing the diagnostic accuracy of qualitative and quantitative assessment of the susceptibility in the precentral gyrus in detecting amyotrophic lateral sclerosis (ALS) with predominance of upper motor neuron (UMN) impairment. Methods: We retrospectively collected clinical and 3T MRI data of 47 ALS patients, of whom 12 with UMN predominance (UMN-ALS). We further enrolled 23 healthy controls (HC) and 15 ALS Mimics (ALS-Mim). The Motor Cortex Susceptibility (MCS) score was qualitatively assessed on the susceptibility-weighted images (SWI) and automatic metrics were extracted from the quantitative susceptibility mapping (QSM) in the precentral gyrus. MCS scores and QSM-based metrics were tested for correlation, and ROC analyses. Results: The correlation of MCS score and susceptibility skewness was significant (Rho = 0.55, p < 0.001). The susceptibility SD showed an AUC of 0.809 with a specificity and positive predictive value of 100% in differentiating ALS and ALS Mim versus HC, significantly higher than MCS (Z = -3.384, p-value = 0.00071). The susceptibility skewness value of -0.017 showed specificity of 92.3% and predictive positive value of 91.7% in differentiating UMN-ALS versus ALS mimics, even if the performance was not significantly better than MCS (Z = 0.81, p = 0.21). Conclusion: The MCS and susceptibility skewness of the precentral gyrus show high diagnostic accuracy in differentiating UMN-ALS from ALS-mimics subjects. The quantitative assessment might be preferred being an automatic measure unbiased by the reader. Clinical relevance statement: The clinical diagnostic evaluation of ALS patients might benefit from the qualitative and/or quantitative assessment of the susceptibility in the precentral gyrus as imaging marker of upper motor neuron predominance. Key points: • Amyotrophic lateral sclerosis diagnostic work-up lacks biomarkers able to identify upper motor neuron involvement. • Susceptibility-weighted imaging/quantitative susceptibility mapping-based measures showed good diagnostic accuracy in discriminating amyotrophic lateral sclerosis with predominant upper motor neuron impairment from patients with suspected motor neuron disorder. • Susceptibility-weighted imaging/quantitative susceptibility mapping-based assessment of the magnetic susceptibility provides a diagnostic marker for amyotrophic lateral sclerosis with upper motor neuron predominance.
MeSH term(s)	Humans ; Amyotrophic Lateral Sclerosis/diagnostic imaging ; Motor Cortex/diagnostic imaging ; Retrospective Studies ; Motor Neurons ; Motor Neuron Disease/diagnostic imaging ; Magnetic Resonance Imaging/methods
Language	English
Publishing date	2023-08-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-10070-y
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Article ; Online: Glue embolization of a pial arteriovenous fistula of the spinal artery.

Doniselli, Fabio Martino / Paolucci, Aldo / Conte, Giorgio / Rampini, Paolo / Arrichiello, Antonio / Triulzi, Fabio Maria

Acta bio-medica : Atenei Parmensis

2020 Volume 91, Issue 10-S, Page(s) e2020004

Abstract: There are no clear guidelines about the treatment Pial Arteriovenous Fistulae (PAVF). For high-risk and severally symptomatic fistulae surgery is the first choice of treatment, including feeding artery ligation, surgical resection, radiosurgery and ... ...

Abstract	There are no clear guidelines about the treatment Pial Arteriovenous Fistulae (PAVF). For high-risk and severally symptomatic fistulae surgery is the first choice of treatment, including feeding artery ligation, surgical resection, radiosurgery and endovascular embolization techniques. We described a case of a patient with a symptomatic PAVF at the craniocervical junction fed by the anterior spinal artery, successfully treated with endovascular approach consisting of glue embolization of the feeding vessel.
MeSH term(s)	Arteries ; Arteriovenous Fistula/diagnostic imaging ; Arteriovenous Fistula/therapy ; Embolization, Therapeutic ; Endovascular Procedures ; Humans ; Treatment Outcome
Language	English
Publishing date	2020-09-23
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v91i10-S.10282
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Article ; Online: Granular cell tumor of the neurohypophysis presenting as a third ventricle mass.

Lopez, Gianluca / Pescia, Carlo / Galli, Carlo / Bramerio, Manuela / Tosoni, Antonella / Nebuloni, Manuela / Ferrara, Mariarosa / Bertani, Giulio / Caschera, Luca / Triulzi, Fabio Maria / Locatelli, Marco / Tabano, Silvia / Croci, Giorgio Alberto

Neuropathology : official journal of the Japanese Society of Neuropathology

2023 Volume 43, Issue 6, Page(s) 472–478

Abstract: Granular cell tumors of the neurohypophysis (GCT) are rare benign neoplasms belonging, along with pituicytoma and spindle cell oncocytoma, to the family of TTF1-positive low-grade neoplasms of the posterior pituitary gland. GCT usually present as a solid ...

Abstract	Granular cell tumors of the neurohypophysis (GCT) are rare benign neoplasms belonging, along with pituicytoma and spindle cell oncocytoma, to the family of TTF1-positive low-grade neoplasms of the posterior pituitary gland. GCT usually present as a solid sellar mass, slowly growing and causing compressive symptoms over time, occasionally with suprasellar extension. They comprise polygonal monomorphous cells with abundant granular cytoplasm, which is ultrastructurally filled with lysosomes. Here we report the case of a GCT presenting as a third ventricle mass, radiologically mimicking chordoid glioma, with aberrant expression of GFAP and Annexin-A, which lends itself as an example of an integrated diagnostic approach to sellar/suprasellar and third ventricle masses.
MeSH term(s)	Humans ; Pituitary Gland, Posterior/metabolism ; Pituitary Gland, Posterior/pathology ; Third Ventricle/diagnostic imaging ; Third Ventricle/pathology ; Granular Cell Tumor/diagnostic imaging ; Granular Cell Tumor/pathology ; Cerebral Ventricle Neoplasms/diagnostic imaging ; Cerebral Ventricle Neoplasms/pathology ; Craniopharyngioma ; Pituitary Neoplasms/diagnostic imaging ; Glioma/pathology
Language	English
Publishing date	2023-05-05
Publishing country	Australia
Document type	Case Reports
ZDB-ID	1483794-8
ISSN	1440-1789 ; 0919-6544
ISSN (online)	1440-1789
ISSN	0919-6544
DOI	10.1111/neup.12907
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Article ; Online: Geometric Reliability of Super-Resolution Reconstructed Images from Clinical Fetal MRI in the Second Trimester.

Ciceri, Tommaso / Squarcina, Letizia / Pigoni, Alessandro / Ferro, Adele / Montano, Florian / Bertoldo, Alessandra / Persico, Nicola / Boito, Simona / Triulzi, Fabio Maria / Conte, Giorgio / Brambilla, Paolo / Peruzzo, Denis

Neuroinformatics

2023 Volume 21, Issue 3, Page(s) 549–563

Abstract: Fetal Magnetic Resonance Imaging (MRI) is an important noninvasive diagnostic tool to characterize the central nervous system (CNS) development, significantly contributing to pregnancy management. In clinical practice, fetal MRI of the brain includes the ...

Abstract	Fetal Magnetic Resonance Imaging (MRI) is an important noninvasive diagnostic tool to characterize the central nervous system (CNS) development, significantly contributing to pregnancy management. In clinical practice, fetal MRI of the brain includes the acquisition of fast anatomical sequences over different planes on which several biometric measurements are manually extracted. Recently, modern toolkits use the acquired two-dimensional (2D) images to reconstruct a Super-Resolution (SR) isotropic volume of the brain, enabling three-dimensional (3D) analysis of the fetal CNS.We analyzed 17 fetal MR exams performed in the second trimester, including orthogonal T2-weighted (T2w) Turbo Spin Echo (TSE) and balanced Fast Field Echo (b-FFE) sequences. For each subject and type of sequence, three distinct high-resolution volumes were reconstructed via NiftyMIC, MIALSRTK, and SVRTK toolkits. Fifteen biometric measurements were assessed both on the acquired 2D images and SR reconstructed volumes, and compared using Passing-Bablok regression, Bland-Altman plot analysis, and statistical tests.Results indicate that NiftyMIC and MIALSRTK provide reliable SR reconstructed volumes, suitable for biometric assessments. NiftyMIC also improves the operator intraclass correlation coefficient on the quantitative biometric measures with respect to the acquired 2D images. In addition, TSE sequences lead to more robust fetal brain reconstructions against intensity artifacts compared to b-FFE sequences, despite the latter exhibiting more defined anatomical details.Our findings strengthen the adoption of automatic toolkits for fetal brain reconstructions to perform biometry evaluations of fetal brain development over common clinical MR at an early pregnancy stage.
MeSH term(s)	Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second ; Imaging, Three-Dimensional/methods ; Reproducibility of Results ; Magnetic Resonance Imaging/methods ; Brain/diagnostic imaging
Language	English
Publishing date	2023-06-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2111941-7
ISSN	1559-0089 ; 1539-2791
ISSN (online)	1559-0089
ISSN	1539-2791
DOI	10.1007/s12021-023-09635-5
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Article ; Online: Correction to: Geometric Reliability of Super-Resolution Reconstructed Images from Clinical Fetal MRI in the Second Trimester.

Neuroinformatics

2023 Volume 21, Issue 4, Page(s) 669

Language	English
Publishing date	2023-09-19
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2111941-7
ISSN	1559-0089 ; 1539-2791
ISSN (online)	1559-0089
ISSN	1539-2791
DOI	10.1007/s12021-023-09642-6
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Article ; Online: Predicting tumor consistency and extent of resection in non-functioning pituitary tumors.

Fiore, Giorgio / Bertani, Giulio Andrea / Conte, Giorgio / Ferrante, Emanuele / Tariciotti, Leonardo / Kuhn, Elisabetta / Runza, Letterio / Pluderi, Mauro / Borsa, Stefano / Caroli, Manuela / Sala, Elisa / Platania, Giulia / Kremenova, Karin / Ferrero, Stefano / Triulzi, Fabio Maria / Mantovani, Giovanna / Locatelli, Marco

Pituitary

2023 Volume 26, Issue 2, Page(s) 209–220

Abstract: Purpose: To (1) identify a radiological parameter to predict non-functioning pituitary tumor (NFPT) consistency, (2) examine the relationship between NFPT consistency and extent of resection (EOR), (3) investigate if tumor consistency predictors can ... ...

Abstract	Purpose: To (1) identify a radiological parameter to predict non-functioning pituitary tumor (NFPT) consistency, (2) examine the relationship between NFPT consistency and extent of resection (EOR), (3) investigate if tumor consistency predictors can anticipate EOR. Methods: The ratio (T2SIR) between the T2 min signal intensity (SI) of the tumor and the T2 mean SI of the CSF was the main radiological parameter, being determined through a radiomic-voxel analysis and calculated using the following formula: T2SIR = [(T2 tumor mean SI - SD)/T2 CSF SI]. The tumor consistency was pathologically estimated as collagen percentage (CP). EOR of NFPTs was evaluated by exploiting a volumetric technique and its relationship with the following explanatory variables was explored: CP, Knosp-grade, tumor volume, inter-carotid distance, sphenoidal sinus morphology, Hardy-grade, suprasellar tumor extension. Results: A statistically significant inverse correlation between T2SIR and CP was demonstrated (p = 0.0001), with high diagnostic power of T2SIR in predicting NFPT consistency (ROC curve analysis' AUC = 0.88; p = 0.0001). The following predictors of EOR were identified in the univariate analysis: CP (p = 0.007), preoperative volume (p = 0.045), Knosp grade (p = 0.0001), tumor suprasellar extension (p = 0.044). The multivariate analysis demonstrated two variables as unique predictors of EOR: CP (p = 0.002) and Knosp grade (p = 0.001). The T2SIR was a significant predictor of EOR both in the univariate (p = 0.01) and multivariate model (p = 0.003). Conclusion: This study offers the potential to improve NFPT preoperative surgical planning and patient counseling by employing the T2SIR as a preoperative predictor of tumor consistency and EOR. Meanwhile, tumor consistency and Knosp grade were found to play an important role in predicting EOR.
MeSH term(s)	Humans ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/surgery ; Pituitary Neoplasms/pathology ; Magnetic Resonance Imaging ; Adenoma/surgery ; Neurosurgical Procedures/methods ; Tumor Burden ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2023-02-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1385151-2
ISSN	1573-7403 ; 1386-341X
ISSN (online)	1573-7403
ISSN	1386-341X
DOI	10.1007/s11102-023-01302-x
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