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4 results on '"Nibali, M. C."'

1. Preoperative brain tumor imaging: models and software for segmentation and standardized reporting

Author

Bouget, D., Pedersen, A., Jakola, A. S., Kavouridis, V., Emblem, K. E., Eijgelaar, R. S., Kommers, I., Ardon, H., Barkhof, F., Bello, L., Berger, M. S., Nibali, M. C., Furtner, J., Hervey-Jumper, S., Idema, A. J. S., Kiesel, B., Kloet, A., Mandonnet, E., Müller, D. M. J., Robe, P. A., Rossi, M., Sciortino, T., Brink, W. Van den, Wagemakers, M., Widhalm, G., Witte, M. G., Zwinderman, A. H., Hamer, P. C. De Witt, Solheim, O., and Reinertsen, I.

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition, Computer Science - Machine Learning, I.4.6, J.3
Abstract

For patients suffering from brain tumor, prognosis estimation and treatment decisions are made by a multidisciplinary team based on a set of preoperative MR scans. Currently, the lack of standardized and automatic methods for tumor detection and generation of clinical reports represents a major hurdle. In this study, we investigate glioblastomas, lower grade gliomas, meningiomas, and metastases, through four cohorts of up to 4000 patients. Tumor segmentation models were trained using the AGU-Net architecture with different preprocessing steps and protocols. Segmentation performances were assessed in-depth using a wide-range of voxel and patient-wise metrics covering volume, distance, and probabilistic aspects. Finally, two software solutions have been developed, enabling an easy use of the trained models and standardized generation of clinical reports: Raidionics and Raidionics-Slicer. Segmentation performances were quite homogeneous across the four different brain tumor types, with an average true positive Dice ranging between 80% and 90%, patient-wise recall between 88% and 98%, and patient-wise precision around 95%. With our Raidionics software, running on a desktop computer with CPU support, tumor segmentation can be performed in 16 to 54 seconds depending on the dimensions of the MRI volume. For the generation of a standardized clinical report, including the tumor segmentation and features computation, 5 to 15 minutes are necessary. All trained models have been made open-access together with the source code for both software solutions and validation metrics computation. In the future, an automatic classification of the brain tumor type would be necessary to replace manual user input. Finally, the inclusion of post-operative segmentation in both software solutions will be key for generating complete post-operative standardized clinical reports., Comment: 20 pages, 5 figures, 10 tables

Published
2022
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2. Advancing Imaging to Enhance Surgery: From Image to Information Guidance

Author

Riva M., Lopci E., Gay L. G., Nibali M. C., Rossi M., Sciortino T., Castellano A., Bello L., Riva, M., Lopci, E., Gay, L. G., Nibali, M. C., Rossi, M., Sciortino, T., Castellano, A., and Bello, L.

Subjects
PET, Presurgical planning, Radiomics, Image guidance, Surgery, Magnetic resonance imaging (MRI), Glioblastoma
Abstract

Conventional magnetic resonance imaging (cMRI) has an established role as a crucial disease parameter in the multidisciplinary management of glioblastoma, guiding diagnosis, treatment planning, assessment, and follow-up. Yet, cMRI cannot provide adequate information regarding tissue heterogeneity and the infiltrative extent beyond the contrast enhancement. Advanced magnetic resonance imaging and PET and newer analytical methods are transforming images into data (radiomics) and providing noninvasive biomarkers of molecular features (radiogenomics), conveying enhanced information for improving decision making in surgery. This review analyzes the shift from image guidance to information guidance that is relevant for the surgical treatment of glioblastoma.

Published
2020

3. Is supratotal resection achievable in low-grade gliomas? Feasibility, putative factors, safety, and functional outcome

Author

Rossi, M, Ambrogi, F, Gay, L, Gallucci, M, Nibali, M, Leonetti, A, Puglisi, G, Sciortino, T, Howells, H, Riva, M, Pessina, F, Navarria, P, Franzese, C, Simonelli, M, Ruda, R, Bello, L, Rossi M., Ambrogi F., Gay L., Gallucci M., Nibali M. C., Leonetti A., Puglisi G., Sciortino T., Howells H., Riva M., Pessina F., Navarria P., Franzese C., Simonelli M., Ruda R., Bello L., Rossi, M, Ambrogi, F, Gay, L, Gallucci, M, Nibali, M, Leonetti, A, Puglisi, G, Sciortino, T, Howells, H, Riva, M, Pessina, F, Navarria, P, Franzese, C, Simonelli, M, Ruda, R, Bello, L, Rossi M., Ambrogi F., Gay L., Gallucci M., Nibali M. C., Leonetti A., Puglisi G., Sciortino T., Howells H., Riva M., Pessina F., Navarria P., Franzese C., Simonelli M., Ruda R., and Bello L.

Abstract

OBJECTIVE Surgery for low-grade gliomas (LGGs) aims to achieve maximal tumor removal and maintenance of patients' functional integrity. Because extent of resection is one of the factors affecting the natural history of LGGs, surgery could be extended further than total resection toward a supratotal resection, beyond tumor borders detectable on FLAIR imaging. Supratotal resection is highly debated, mainly due to a lack of evidence of its feasibility and safety. The authors explored the intraoperative feasibility of supratotal resection and its short- and long-term impact on functional integrity in a large cohort of patients. The role of some putative factors in the achievement of supratotal resection was also studied. METHODS Four hundred forty-nine patients with a presumptive radiological diagnosis of LGG consecutively admitted to the neurosurgical oncology service at the University of Milan over a 5-year period were enrolled. In all patients, a policy was adopted to perform surgery according to functional boundaries, aimed at achieving a supratotal resection whenever possible, without any patient or tumor a priori selection. Feasibility, general safety, and tumor or patient putative factors possibly affecting the achievement of a supratotal resection were analyzed. Postsurgical patient functional performance was evaluated in five cognitive domains (memory, language, praxis, executive functions, and fluid intelligence) using a detailed neuropsychological evaluation and quality of life (QOL) examination. RESULTS Total resection was feasible in 40.8% of patients, and supratotal resection in 32.3%. The achievement of a supratotal versus total resection was independent of age, sex, education, tumor volume, deep extension, location, handedness, appearance of tumor border, vicinity to eloquent sites, surgical mapping time, or surgical tools applied. Supratotal resection was associated with a long clinical history and histological grade II, suggesting that reshaping of bra

Published
2020

4. Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas

Author

Zanello, M, Goodden, J, Colle, H, Wager, M, Hamer, P, Smits, A, Bello, L, Tate, M, Spena, G, Bresson, D, Capelle, L, Robles, S, Sarubbo, S, Rydenhag, B, Martino, J, Meyer, B, Fontaine, D, Reyns, N, Schichor, C, Metellus, P, Colle, D, Robert, E, Noens, B, Muller, P, Rossi, M, Nibali, M, Papagno, C, Galbarritu, L, De Gopegui, E, Chioffi, F, Bucheli, C, Krieg, S, Wostrack, M, Yusupov, N, Visser, V, Baaijen, J, Roux, A, Dezamis, E, Mandonnet, E, Corns, R, Duffau, H, Pallud, J, Zanello M., Goodden J. R., Colle H., Wager M., Hamer P. C. D. W., Smits A., Bello L., Tate M., Spena G., Bresson D., Capelle L., Robles S. G., Sarubbo S., Rydenhag B., Martino J., Meyer B., Fontaine D., Reyns N., Schichor C., Metellus P., Colle D., Robert E., Noens B., Muller P., Rossi M., Nibali M. C., Papagno C., Galbarritu L., De Gopegui E. R., Chioffi F., Bucheli C., Krieg S. M., Wostrack M., Yusupov N., Visser V., Baaijen J. C., Roux A., Dezamis E., Mandonnet E., Corns R., Duffau H., Pallud J., Zanello, M, Goodden, J, Colle, H, Wager, M, Hamer, P, Smits, A, Bello, L, Tate, M, Spena, G, Bresson, D, Capelle, L, Robles, S, Sarubbo, S, Rydenhag, B, Martino, J, Meyer, B, Fontaine, D, Reyns, N, Schichor, C, Metellus, P, Colle, D, Robert, E, Noens, B, Muller, P, Rossi, M, Nibali, M, Papagno, C, Galbarritu, L, De Gopegui, E, Chioffi, F, Bucheli, C, Krieg, S, Wostrack, M, Yusupov, N, Visser, V, Baaijen, J, Roux, A, Dezamis, E, Mandonnet, E, Corns, R, Duffau, H, Pallud, J, Zanello M., Goodden J. R., Colle H., Wager M., Hamer P. C. D. W., Smits A., Bello L., Tate M., Spena G., Bresson D., Capelle L., Robles S. G., Sarubbo S., Rydenhag B., Martino J., Meyer B., Fontaine D., Reyns N., Schichor C., Metellus P., Colle D., Robert E., Noens B., Muller P., Rossi M., Nibali M. C., Papagno C., Galbarritu L., De Gopegui E. R., Chioffi F., Bucheli C., Krieg S. M., Wostrack M., Yusupov N., Visser V., Baaijen J. C., Roux A., Dezamis E., Mandonnet E., Corns R., Duffau H., and Pallud J.

Abstract

BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.

Published
2019

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