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The piece is owned by the San Francisco Museum of Fine Arts and is the only da Sesto painting in the United States. There are approximately 30 known paintings by the Italian master, who lived from 1477 to 1523. The Museum of Fine Arts turned to Modestini when they realized the restoration was a bigger job than they could handle.

Modestini, who works at IFA's Conservation Center, says the painting was "the most difficult thing I've ever worked on in my life." She says paint had flaked off a large percentage of the enormous 8 feet by 7 feet altarpiece. Da Sesto originally applied the paint to four wood panels joined by butterfly wedges, and over time, a lot of shifting occurred, causing the paint to crack.

Modestini was fortunate in one respect. No detective work was required to figure out how the previous restoration had been done. Mario Modestini, her 98-year-old husband, restored the work soon after World War II, in Rome. Dianne Modestini says that because of war shortages, petroleum-based varnishes were hard to come by so her husband collected pine resin from trees to fashion his own varnish.

Pine resin varnish darkens more quickly than the petroleum-based type and when Dianne Modestini got the painting three years ago, restoration was definitely in order. She says the painting was in such bad shape that it could no longer be exhibited. For repainting, she used polyvinyl acetate resin with dry pigments.

Cesare da Sesto was a close follower of Leonardo da Vinci and traveled to Rome in 1508 to work for Pope Julius II. While in Rome, he developed a friendship with Raphael, who had a great influence on his work. The Madonna and Child with Saint John the Baptist and Saint George is considered to be one of the finest examples of high Renaissance altarpieces. Modestini says da Sesto was "a brilliant draftsman."