EMANUELE MORENA

Dottore di ricerca

ciclo: XXXVI


supervisore: Prof. Marco Salvetti

Titolo della tesi: CLUSTERING AND SEGMENTATION OF MULTIPLE SCLEROSIS LESIONS: A DEEP LEARNING EXPLORATION

Introduction: Multiple Sclerosis (MS) is an autoimmune and inflammatory disease characterised by typical demyelinating ‘lesions’ of brain and spinal cord. Magnetic Resonance Imaging (MRI) is the key tool to diagnose and classify MS in phenotypes. The widespread diffusion of MRI for clinical and research purposes, is leading to a steady increase of MS imaging data. Artificial Intelligence (AI) can process this amount of information in a controlled and faster manner than humans. Moreover, the Deep Learning (DL) approach takes advantage from unsupervised representations to recognized pattern using multimodal information. Starting from a visionary idea to overcome unsolved issues in MS, as aetiology and pathology of the disease, we tried to develop an exploratory and unsupervised DL approach to evaluate MRI lesions distribution. Objectives: I) to cluster MS patients applying an unsupervised approach on lesions distribution maps, correlating with clinical and radiological features; II) to evaluate the DL approach’s performance in lesion segmentation of in-house MRI images, compared to manually segmented maps. Method: we decided to use a DL approach called U-Net for our purpose. U-net is developed to segment the lesions. Moreover, we extracted a low dimensional embedding of imaging characteristics, resulting in a vector. We applied a principal components analysis (PCA) to select the directions of maximum variance in the data. Ultimately, a classic K-means algorithm was used for clustering. We chosed to explore K={2,3,4,5}. Preliminary results: 299 patients were evaluated for an amount of 707 exams sessions. No significant correlations between clustering and activity, disability and MS phenotypes characteristics were found. Significant associations were found with age, k=2 (OR 0.932, 95%CI [0.894, 0.970]) and k=4 (OR 1.059, 95%CI[1.009, 1.117]), sex, k=3(OR 28.875, 95%CI [7.935, 148.531]) and k=4 (OR 21.625, 95%CI[6.065, 108.357]) and disease duration, K=5 (OR 1.119, 95%CI[1.045,1.216]). Compared to manually, U-Net confirmed its high capacity in lesions segmentation, with accuracy (99.98±0.02), sensitivity (89.14±6.11) and specificity (99.99±0.01). Conclusions: Our study demonstrate that U-Net and k-means are useful for lesion segmentations and clustering of patients’ lesions map using an unsupervised approach. However, this study should be considered as an initial step of a figured wider project, since it reported very preliminary results. Our initial idea was to use an exploratory DL approach to solve the complex and unreached issues in MS, e.g. the etiology of the disease. We are aware that this goal is very far from being achieved and that many research efforts, advanced imaging techniques and biological information are still needed to do that.

Produzione scientifica

11573/1680147 - 2023 - Peripheral Biomarkers in Manifest and Premanifest Huntington’s Disease
Morena, Emanuele; Romano, Carmela; Marconi, Martina; Diamant, Selene; Buscarinu, Maria Chiara; Bellucci, Gianmarco; Romano, Silvia; Scarabino, Daniela; Salvetti, Marco; Ristori, Giovanni - 01g Articolo di rassegna (Review)
rivista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (Basel: MDPI Center) pp. 6051- - issn: 1422-0067 - wos: WOS:000970158400001 (3) - scopus: 2-s2.0-85152353047 (2)

11573/1646132 - 2022 - Late-Onset MS: Disease Course and Safety-Efficacy of DMTS
Buscarinu, M. C.; Renie, R.; Morena, E.; Romano, C.; Bellucci, G.; Marrone, A.; Bigi, R.; Salvetti, M.; Ristori, G. - 01a Articolo in rivista
rivista: FRONTIERS IN NEUROLOGY (Lausanne: Frontiers Research Foundation, 2010-) pp. 829331- - issn: 1664-2295 - wos: WOS:000780469800001 (14) - scopus: 2-s2.0-85127372856 (15)

11573/1672936 - 2022 - CADASIL or MS? Consider “Red Flags” but Avoid a Misdiagnosis: Case Series of a Concomitant Diagnosis
Morena, Emanuele; Lucchini, Matteo; Romano, Carmela; Petrucci, Simona; Tartaglia, Matteo; Morosetti, Roberta; Conte, Antonella; Buscarinu, Maria Chiara; Romano, Silvia; Salvetti, Marco; Mirabella, Massimiliano; Ristori, Giovanni - 01i Case report
rivista: ARCHIVES OF CLINICAL AND MEDICAL CASE REPORTS (Houston TX: Fortune Journals) pp. - - issn: 2575-9655 - wos: (0) - scopus: (0)

11573/1672940 - 2022 - Imaging Characteristics of Choroid Plexuses in Presymptomatic Multiple Sclerosis. A Retrospective Study
Ricigliano, Vito A G; Louapre, Céline; Poirion, Emilie; Colombi, Annalisa; Yazdan Panah, Arya; Lazzarotto, Andrea; Morena, Emanuele; Martin, Elodie; Bottlaender, Michel; Bodini, Benedetta; Seilhean, Danielle; Stankoff, Bruno - 01a Articolo in rivista
rivista: NEUROLOGY® NEUROIMMUNOLOGY & NEUROINFLAMMATION (Baltimore, MD : Wolters Kluwer Health/Lippincott Williams & Wilkins [2014]-) pp. 1-11 - issn: 2332-7812 - wos: WOS:000874687300018 (14) - scopus: 2-s2.0-85139812051 (17)

11573/1646140 - 2022 - Circulating U13 Small Nucleolar RNA as a Potential Biomarker in Huntington’s Disease: A Pilot Study
Romano, Silvia; Romano, Carmela; Peconi, Martina; Fiore, Alessia; Bellucci, Gianmarco; Morena, Emanuele; Troili, Fernanda; Cipollini, Virginia; Annibali, Viviana; Giglio, Simona; Mechelli, Rosella; Ferraldeschi, Michela; Veneziano, Liana; Mantuano, Elide; Sani, Gabriele; Vecchione, Andrea; Umeton, Renato; Giubilei, Franco; Salvetti, Marco; Corbo, Rosa Maria; Scarabino, Daniela; Ristori, Giovanni - 01a Articolo in rivista
rivista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (Basel (Matthaeustrasse 11) : Molecular Diversity Preservation International MDPI) pp. 12440- - issn: 1661-6596 - wos: WOS:000873041100001 (1) - scopus: 2-s2.0-85140829236 (1)

11573/1693891 - 2022 - Circulating U13 small nucleolar RNA as a candidate biomarker for Huntington's disease: A Pilot Study
Romano, Silvia; Romano, Carmela; Peconi, Martina; Fiore, Alessia; Bellucci, Gianmarco; Morena, Emanuele; Troili, Fernanda; Cipollini, Virginia; Annibali, Viviana; Giglio, Simona; Mechelli, Rosella; Ferraldeschi, Michela; Veneziano, Liana; Mantuano, Elide; Sani, Gabriele; Vecchione, Andrea; Umeton, Renato; Giubilei, Franco; Salvetti, Marco; Corbo, Rosa Maria; Scarabino, Daniela; Ristori, Giovanni - 01a Articolo in rivista
rivista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (Basel: MDPI Center) pp. - - issn: 1422-0067 - wos: (0) - scopus: (0)

11573/1645980 - 2022 - Multiple sclerosis genetic and non-genetic factors interact through the transient transcriptome
Umeton, R.; Bellucci, G.; Bigi, R.; Romano, S.; Buscarinu, M. C.; Renie, R.; Rinaldi, V.; Pizzolato Umeton, R.; Morena, E.; Romano, C.; Mechelli, R.; Salvetti, M.; Ristori, G. - 01a Articolo in rivista
rivista: SCIENTIFIC REPORTS (London: Springer Nature London: Nature Publishing Group) pp. 7536- - issn: 2045-2322 - wos: WOS:000792845300065 (3) - scopus: 2-s2.0-85129540836 (3)

11573/1560921 - 2021 - A case of double standard. Sex differences in multiple sclerosis risk factors
Angeloni, B.; Bigi, R.; Bellucci, G.; Mechelli, R.; Ballerini, C.; Romano, C.; Morena, E.; Pellicciari, G.; Renie, R.; Rinaldi, V.; Buscarinu, M. C.; Romano, S.; Ristori, G.; Salvetti, M. - 01g Articolo di rassegna (Review)
rivista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (Basel (Matthaeustrasse 11) : Molecular Diversity Preservation International MDPI) pp. 1-11 - issn: 1661-6596 - wos: WOS:000638663500001 (11) - scopus: 2-s2.0-85103515267 (11)

11573/1616249 - 2021 - Multiple Sclerosis and SARS-CoV-2: Has the Interplay Started?
Bellucci, G.; Rinaldi, V.; Buscarinu, M. C.; Renie, R.; Bigi, R.; Pellicciari, G.; Morena, E.; Romano, C.; Marrone, A.; Mechelli, R.; Salvetti, M.; Ristori, G. - 01a Articolo in rivista
rivista: FRONTIERS IN IMMUNOLOGY (Lausanne : Frontiers Research Foundation, 2010-) pp. 755333- - issn: 1664-3224 - wos: WOS:000726179400001 (27) - scopus: 2-s2.0-85116922341 (29)

11573/1566203 - 2021 - Intestinal Permeability and Circulating CD161+CCR6+CD8+T Cells in Patients With Relapsing–Remitting Multiple Sclerosis Treated With Dimethylfumarate
Buscarinu, Maria C.; Gargano, Francesca; Lionetto, Luana; Capi, Matilde; Morena, Emanuele; Fornasiero, Arianna; Reniè, Roberta; Landi, Anna C.; Pellicciari, Giulia; Romano, Carmela; Mechelli, Rosella; Romano, Silvia; Borsellino, Giovanna; Battistini, Luca; Simmaco, Maurizio; Fagnani, Corrado; Salvetti, Marco; Ristori, Giovanni - 01a Articolo in rivista
rivista: FRONTIERS IN NEUROLOGY (Lausanne: Frontiers Research Foundation, 2010-) pp. - - issn: 1664-2295 - wos: WOS:000728830600001 (5) - scopus: 2-s2.0-85114630306 (4)

11573/1549835 - 2021 - Circulating hsa-miR-323b-3p in Huntington's Disease. A Pilot Study
Ferraldeschi, M.; Romano, S.; Giglio, S.; Romano, C.; Morena, E.; Mechelli, R.; Annibali, V.; Ubaldi, M.; Buscarinu, M. C.; Umeton, R.; Sani, G.; Vecchione, A.; Salvetti, M.; Ristori, G. - 01a Articolo in rivista
rivista: FRONTIERS IN NEUROLOGY (Lausanne: Frontiers Research Foundation, 2010-) pp. 1-7 - issn: 1664-2295 - wos: WOS:000651757800001 (8) - scopus: 2-s2.0-85105979144 (9)

11573/1560913 - 2021 - Mait cells and microbiota in multiple sclerosis and other autoimmune diseases
Mechelli, R.; Romano, S.; Romano, C.; Morena, E.; Buscarinu, M. C.; Bigi, R.; Bellucci, G.; Renie, R.; Pellicciari, G.; Salvetti, M.; Ristori, G. - 01g Articolo di rassegna (Review)
rivista: MICROORGANISMS (Basel : MDPI) pp. 1-13 - issn: 2076-2607 - wos: WOS:000666799700001 (11) - scopus: 2-s2.0-85106275813 (10)

11573/1621674 - 2021 - Choroid plexus enlargement in inflammatory multiple sclerosis: 3.0-T MRI and translocator protein PET evaluation
Ricigliano, V. A. G.; Morena, E.; Colombi, A.; Tonietto, M.; Hamzaoui, M.; Poirion, E.; Bottlaender, M.; Gervais, P.; Louapre, C.; Bodini, B.; Stankoff, B. - 01a Articolo in rivista
rivista: RADIOLOGY (Radiological Society of North America:820 Jorie Boulevard:Oak Brook, IL 60523:(630)571-7873, EMAIL: subscrib@rsna.org, INTERNET: http://www.rsna.org, Fax: (630)571-7837) pp. 166-177 - issn: 0033-8419 - wos: WOS:000698513000040 (9) - scopus: 2-s2.0-85116070880 (9)

11573/1358336 - 2020 - Disentangling the molecular mechanisms of multiple sclerosis: the contribution of twin studies
Buscarinu, M. C.; Fornasiero, A.; Ferraldeschi, M.; Romano, S.; Renie, R.; Morena, E.; Romano, C.; Pellicciari, G.; Landi, A. C.; Fagnani, C.; Salvetti, M.; Ristori, G. - 01g Articolo di rassegna (Review)
rivista: NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS (Elsevier Science Limited:Oxford Fulfillment Center, PO Box 800, Kidlington Oxford OX5 1DX United Kingdom:011 44 1865 843000, 011 44 1865 843699, EMAIL: asianfo@elsevier.com, tcb@elsevier.co.UK, INTERNET: http://www.elsevier.com, http://www.elsevier.com/locate/shpsa/, Fax: 011 44 1865 843010) pp. 194-198 - issn: 0149-7634 - wos: WOS:000517663900016 (4) - scopus: 2-s2.0-85078312434 (5)

11573/1477823 - 2020 - Corrigendum: Perivascular Unit: This Must Be the Place. The Anatomical Crossroad Between the Immune, Vascular and Nervous System (Frontiers in Neuroanatomy, (2020), 14, 10.3389/fnana.2020.00017)
Troili, F.; Cipollini, V.; Moci, M.; Morena, E.; Palotai, M.; Rinaldi, V.; Romano, C.; Ristori, G.; Giubilei, F.; Salvetti, M.; Orzi, F.; Guttmann, C. R. G.; Cavallari, M. - 01b Commento, Erratum, Replica e simili
rivista: FRONTIERS IN NEUROANATOMY (Lausanne : Frontiers Research Foundation, 2007-) pp. 51- - issn: 1662-5129 - wos: WOS:000576084100001 (0) - scopus: 2-s2.0-85091770391 (7)

11573/1574278 - 2020 - Perivascular unit: this must be the place. The anatomical crossroad between the immune, vascular and nervous system
Troili, F; Cipollini, V; Moci, M; Morena, E; Palotai, M; Rinaldi, V; Romano, C; Ristori, G; Giubilei, F; Salvetti, M; Orzi, F; Guttmann, Crg; Cavallari, M - 01g Articolo di rassegna (Review)
rivista: FRONTIERS IN NEUROANATOMY (Lausanne : Frontiers Research Foundation, 2007-) pp. 14-17 - issn: 1662-5129 - wos: WOS:000531196200001 (41) - scopus: 2-s2.0-85084082947 (32)

11573/1318638 - 2019 - The contribution of gut barrier changes to multiple sclerosis pathophysiology
Buscarinu, M. C.; Fornasiero, A.; Romano, S.; Ferraldeschi, M.; Mechelli, R.; Renie, R.; Morena, E.; Romano, C.; Pellicciari, G.; Landi, A. C.; Salvetti, M.; Ristori, G. - 01g Articolo di rassegna (Review)
rivista: FRONTIERS IN IMMUNOLOGY (Lausanne : Frontiers Research Foundation, 2010-) pp. 1916- - issn: 1664-3224 - wos: WOS:000482914000001 (34) - scopus: 2-s2.0-85072047265 (34)

11573/1318032 - 2019 - Drug holiday of interferon beta 1b in multiple sclerosis: A Pilot, Randomized, Single Blind Study of Non-inferiority
Romano, S.; Ferraldeschi, M.; Bagnato, F.; Mechelli, R.; Morena, E.; Caldano, M.; Buscarinu, M. C.; Fornasiero, A.; Frontoni, M.; Nociti, V.; Mirabella, M.; Mayer, F.; Bertolotto, A.; Pozzilli, C.; Vanacore, N.; Salvetti, M.; Ristori, G. - 01a Articolo in rivista
rivista: FRONTIERS IN NEUROLOGY (Lausanne: Frontiers Research Foundation, 2010-) pp. 695- - issn: 1664-2295 - wos: WOS:000475829600001 (5) - scopus: 2-s2.0-85069772711 (5)

11573/1031434 - 2018 - Intestinal Permeabiliy in Relapsing-Remitting Multiple Sclerosis
Buscarinu, M. C.; Romano, S.; Mechelli, R.; Pizzolato Umeton, R.; Ferraldeschi, M.; Fornasiero, A.; Reniã, R.; Cerasoli, B.; Morena, Emanuele; Romano, Carmela; Loizzo, N. D.; Umeton, R.; Salvetti, M.; Ristori, G. - 01a Articolo in rivista
rivista: NEUROTHERAPEUTICS (Orlando, FL: Elsevier, c2007-) pp. 1-7 - issn: 1933-7213 - wos: WOS:000424080900007 (49) - scopus: 2-s2.0-85033374968 (54)

11573/1136908 - 2018 - Chapter 3 - Bacille Calmette-Guérin (BCG) Vaccine in Neuroinflammation
Romano, Silvia; Ferraldeschi, Michela; Buscarinu, Maria Chiara; Fornasiero, Arianna; Renie', Roberta; Morena, Emanuele; Romano, Carmela; Mechell, Rosella; Vanacore, Nicola; Salvetti, Marco; Ristori, Giovanni - 02b Commentario
libro: The Value of BCG and TNF in Autoimmunity - (9780128146033)

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