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1. Whole-body MR imaging in suspected physical child abuse: comparison with skeletal survey and bone scintigraphy findings from the PEDIMA prospective multicentre study

Author: Proisy, Maïa, Vivier, Pierre-Hugues, Morel, Baptiste, Bruneau, Bertrand, Sembely-Taveau, Catherine, Vacheresse, Solène, Devillers, Anne, Lecloirec, Joseph, Bodet-Milin, Caroline, Dubois, Marine, Hamonic, Stéphanie, Bajeux, Emma, Ganivet, Anne, Adamsbaum, Catherine, Treguier, Catherine, Abalea, Lydie, Croly-Labourdette, Séverine, Dam Hieu, Phong, Dobrzynski, Murielle, Fenoll, Bertrand, Forlodou, Pierre, Le Bot, Christiane, Lefranc, Jérémie, Lesoeur, Mélanie, Mériot, Philippe, Peudenier, Sylviane, Querello, Solène, Salaun, Pierre Yves, Olivier, Pierre, Martrille, Laurent, Borsa-Dorion, Anne, Galloy, Marie-Agnès, Mainard-Simard, Laurence, Raffo, Emmanuel, Cavare-Vigneron, Sylvie, Claudon, Michel, Klein, Olivier, Schmitt, Emmanuelle, Le Tacon, Serge, Morel, Olivier, Lapp, Lucie, Bodere-Kraeber, Françoise, Milin, Caroline, Fleury, Juliette, Geffroy, Loïc, Hamel, Sophie, Lefrancois, Thomas, Longis, Marie-Pierre, Mayrargue, Emmanuelle, Picherot, Georges, Quéré, Marie-Pierre, Rozé, Jean-Christophe, Vabres, Nathalie, Bouvet, Renaud, Le Gueut, Mariannick, Riffaud, Laurent, Balençon, Martine, Bétrémieux, Pierre, Chapuis, Madeleine, Chasle, Véronique, Dabadie, Alain, Damaj, Léna, Darnault, Pierre, de La Brière, François, Delahaye, Séverine, Duvauferrier, Regis, Farges, Céline, Fraisse, Bernard, Gaillot, Théophile, Gardin, Maryse, Gauvrit, Cécile, Guitteny, Marie-Aline, Marleix, Sylvette, Napuri, Silvia, Roussey, Michel, Rozel, Céline, Tirel, Olivier, Vignaud, Catherine, Violas, Philippe, Wodey, Eric, Pierre, Marion, Pladys, Patrick, Abu-Amara, Saad, Bachy, Bruno, Brasseur-Daudruy, Marie, Dacher, Jean-Nicolas, Delmon, Pascal, Lechevallier-Amara, Joël, Lerebours, Bénédicte, Leroux, Julien, Proust, Francois, Rigal, Sophie, Baulieu, Jean-Louis, Venel, Yann, Elodie, Carpentier, Chantepie, Alain, Chantreuil, Julie, Come, Mathieu, de Courtivron, Benoit, Labarthe, François, Marot, Yves, Pepin-Donat, Myriam, Sirinelli, Dominique, Travers, Nadine, Urvois-Grange, Annie, O'Byrne, Patrick, Listrat, Antoine, Barge-Galern, Marie-Luce, Le Cloirec, Joseph, Vera, Pierre, Kone-Paut, I., Deiva, Kumaran, Chaumet-Riffaud, Philippe, Grimon, Gilles, Archambaud, Frederique, Zenkhri, Ferielle, Galeotti, Caroline, Sevette-Béchard, Nancy, Prodhomme, Olivier, Leconte, Céline, Haquet, Armelle, Bourdon, Aurélie, Sainmont, Mélanie, De-Pontual, Loic, Sellier, Nicolas, Trieu, Thanh-Van, de Labriolle-Vaylet, Claire, Département de Radiologie [Rennes], Université de Rennes (UR), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Département de médecine nucléaire [Rennes], CRLCC Eugène Marquis (CRLCC), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Rennes], Département de Radiologie [AP-HP Hôpital Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), PEDIMA study research group: Lydie Abalea, Séverine Croly-Labourdette, Phong Dam Hieu, Murielle Dobrzynski, Bertrand Fenoll, Pierre Forlodou, Christiane Le Bot, Jérémie Lefranc, Mélanie Lesoeur, Philippe Meriot, Sylviane Peudenier, Solène Querello, Pierre-Yves Salaun, Pierre Olivier, Laurent Martrille, Anne Borsa-Dorion, Marie-Agnès Galloy, Laurence Mainard-Simard, Emmanuel Raffo, Sylvie Cavare-Vigneron, Michel Claudon, Olivier Klein, Emmanuelle Schmitt, Serge Le Tacon, Olivier Morel, Lucie Lapp, Françoise Bodéré-Kraeber, Caroline Milin, Juliette Fleury, Loïc Geffroy, Sophie Hamel, Antoine Hamel, Thomas Lefrançois, Marie-Pierre Longis, Emmanuelle Mayrargue, Georges Picherot, Marie-Pierre Quéré, Jean-Christophe Rozé, Nathalie Vabres, Renaud Bouvet, Mariannick Le Gueut, Laurent Riffaud, Martine Balençon, Pierre Bétrémieux, Madeleine Chapuis, Véronique Chasle, Alain Dabadie, Léna Damaj, Pierre Darnault, François De La Brière, Séverine Delahaye, Régis Duvauferrier, Céline Farges, Bernard Fraisse, Théophile Gaillot, Maryse Gardin, Cécile Gauvrit, Marie-Aline Guitteny, Sylvette Marleix, Silvia Napuri, Michel Roussey, Céline Rozel, Olivier Tirel, Catherine Tréguier, Catherine Vignaud, Philippe Violas, Eric Wodey, Marion Pierre, Patrick Pladys, Saad Abu-Amara, Bruno Bachy, Marie Brasseur-Daudruy, Jean-Nicolas Dacher, Pascal Delmon, Joël Lechevallier Amara, Bénédicte Lerebours, Julien Leroux, François Proust, Sophie Rigal, Pierre-Hugues Vivier, Jean-Louis Baulieu, Yann Venel, Elodie Carpentier, Alain Chantepie, Julie Chantreuil, Mathieu Come, Benoît De Courtivron, François Labarthe, Yves Marot, Myriam Pepin Donat, Dominique Sirinelli, Nadine Travers, Annie Urvois-Grangé, Patrick O'Byrne, Antoine Listrat, Marie-Luce Barge-Galerne, Joseph Le Cloirec, Pierre Vera, Isabelle Koné-Paut, Kumaran Deiva, Philippe Chaumet-Riffaud, Gilles Grimon, Frédérique Archambaud, Ferielle Zenkhri, Caroline Galeotti, Nancy Sevette Béchard, Olivier Prodhomme, Céline Leconte, Armelle Haquet, Aurélie Bourdon, Mélanie Sainmont, Loïc De Pontual, Nicolas Sellier, Thanh-Van Trieu, Claire De Labriolle-Vaylet., Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), and DACHER, Jean Nicolas
Subjects: Child abuse, medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Skeletal survey, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Sensitivity and Specificity, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 0302 clinical medicine, parasitic diseases, medicine, Humans, Whole Body Imaging, Radiology, Nuclear Medicine and imaging, Child Abuse, Prospective Studies, Child, Radionuclide Imaging, Neuroradiology, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, medicine.diagnostic_test, business.industry, Infant, Interventional radiology, Magnetic resonance imaging, General Medicine, Magnetic Resonance Imaging, Occult, Confidence interval, 3. Good health, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Physical Abuse, Bone scintigraphy, 030220 oncology & carcinogenesis, Radiology, Tomography, X-Ray Computed, business
Abstract: International audience; Objectives: To assess the contribution of whole-body magnetic resonance imaging (WBMRI) and bone scintigraphy (BS) in addition to skeletal survey (SS) in detecting traumatic bone lesions and soft-tissue injuries in suspected child abuse.Methods: In this prospective, multicentre, diagnostic accuracy study, children less than 3 years of age with suspected physical abuse were recruited. Each child underwent SS, BS and WBMRI. A blinded first review was performed in consensus by five paediatric radiologists and three nuclear medicine physicians. A second review investigated discrepancies reported between the modalities using a consensus result of all modalities as the reference standard. We calculated the sensitivity, specificity and corresponding 95% confidence interval for each imaging modality (SS, WBMRI and BS) and for the combinations [SS + WBMRI] and [SS + BS].Results: One hundred seventy children were included of which sixty-four had at least one lesion. In total, 146 lesions were included. The sensitivity and specificity of each examination were, respectively, as follows: 88.4% [95% CI, 82.0-93.1] and 99.7% [95% CI, 99.5-99.8] for the SS, 69.9% [95% CI, 61.7-77.2] and 99.5% [95% CI, 99.2-99.7] for WBMRI and 54.8% [95% CI, 46.4-63.0] and 99.7% [95% CI, 99.5-99.9] for BS. Sensitivity and specificity were, respectively, 95.9% [95% CI, 91.3-98.5] and 99.2% [95% CI, 98.9-99.4] for the combination SS + WBMRI and 95.2% [95% CI, 90.4-98.1] and 99.4% [95% CI, 99.2-99.6] for the combination SS + BS, with no statistically significant difference between them.Conclusion: SS was the most sensitive independent imaging modality; however, the additional combination of either WBMRI or BS examinations offered an increased accuracy.Key points: • SS in suspected infant abuse was the most sensitive independent imaging modality in this study, especially for detecting metaphyseal and rib lesions, and remains essential for evaluation. • The combination of either SS + BS or SS + WBMRI provides greater accuracy in diagnosing occult and equivocal bone injuries in the difficult setting of child abuse. • WBMRI is a free-radiation technique that allows additional diagnosis of soft-tissue and visceral injuries.
Published: 2021

2. Red cell volume measurement – using indium as a replacement for chromium

Author: Stéphanie Becker, David Tonnelet, Juliette Dinet, Pierre Bohn, Joseph Le Cloirec, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Chromium, [SDV]Life Sciences [q-bio], chemistry.chemical_element, 030204 cardiovascular system & hematology, MESH: Chromium Radioisotopes, Red cell volume, Technetium, Chromium Radioisotopes, Indium, Cell size, 03 medical and health sciences, MESH: Chromium, 0302 clinical medicine, Erythrocyte volume, Medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Letters to the Editor, ComputingMilieux_MISCELLANEOUS, MESH: Cell Size, Cell Size, Erythrocyte Volume, business.industry, Chemistry, Radiochemistry, Indium Radioisotopes, General Medicine, MESH: Indium, Red cell volume measurement, Isotope Labeling, MESH: Technetium, business, Biomedical engineering
Abstract: The withdrawal of Cr-chromate has meant that the technique commonly used for direct measurement of red cell volume has had to be replaced. Most centres moved to a Tc erythrocyte label, however, Tc is known to dissociate over time. We have investigated an alternative technique using an In-chloride and tropolone solution and tested this both in vitro and in vivo. Initial in-vitro and in-vivo work, which included a check of the stability of the radio-labelled product at one hour, demonstrated this label to be stable over this time period. To date, 20 patients have undergone this technique and results show that this technique is a viable alternative to Cr-chromate particularly for patients with splenomegaly who require late sampling. This procedure is now in routine use in our institution.
Published: 2020

3. Impact of the Bayesian penalized likelihood algorithm (Q.Clear®) in comparison with the OSEM reconstruction on low contrast PET hypoxic images

Author: Pierre Vera, Pierre Decazes, Bertrand Barres, Edgar Texte, Agathe Edet-Sanson, P. Gouel, Sébastien Thureau, Sébastien Hapdey, J. Lequesne, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Département de radiothérapie et de physique médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: lcsh:Medical physics. Medical radiology. Nuclear medicine, Penalized likelihood, Image quality, PET/CT, [SDV]Life Sciences [q-bio], lcsh:R895-920, Bayesian probability, Biomedical Engineering, BPL reconstruction, NSCLC, Imaging phantom, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Low contrast, Radiology, Nuclear Medicine and imaging, Hypoxia, Instrumentation, Original Research, Mathematics, PET-CT, Radiation, business.industry, Reconstruction algorithm, Thresholding, 030220 oncology & carcinogenesis, Nuclear medicine, business
Abstract: Purpose To determine the impact of the Bayesian penalized likelihood (BPL) reconstruction algorithm in comparison to OSEM on hypoxia PET/CT images of NSCLC using 18F-MIZO and 18F-FAZA. Materials and methods Images of low-contrasted (SBR = 3) micro-spheres of Jaszczak phantom were acquired. Twenty patients with lung neoplasia were included. Each patient benefitted from 18F-MISO and/or 18F-FAZA PET/CT exams, reconstructed with OSEM and BPL. Lesion was considered as hypoxic if the lesion SUVmax > 1.4. A blind evaluation of lesion detectability and image quality was performed on a set of 78 randomized BPL and OSEM images by 10 nuclear physicians. SUVmax, SUVmean, and hypoxic volumes using 3 thresholding approaches were measured and compared for each reconstruction. Results The phantom and patient datasets showed a significant increase of quantitative parameters using BPL compared to OSEM but had no impact on detectability. The optimal beta parameter determined by the phantom analysis was β350. Regarding patient data, there was no clear trend of image quality improvement using BPL. There was no correlation between SUVmax increase with BPL and either SUV or hypoxic volume from the initial OSEM reconstruction. Hypoxic volume obtained by a SUV > 1.4 thresholding was not impacted by the BPL reconstruction parameter. Conclusion BPL allows a significant increase in quantitative parameters and contrast without significantly improving the lesion detectability or image quality. The variation in hypoxic volume by BPL depends on the method used but SUV > 1.4 thresholding seems to be the more robust method, not impacted by the reconstruction method (BPL or OSEM). Trial registration ClinicalTrials.gov, NCT02490696. Registered 1 June 2015
Published: 2020

4. Prognostic value of sarcopenia in patients treated by Radiochemotherapy for locally advanced oesophageal cancer

Author: Pierre Vera, Romain Modzelewski, R. Mallet, Sébastien Thureau, Ahmed Benyoucef, Bernard Dubray, H. Auvray, Frédéric Di Fiore, Sorina Dana Mihailescu, J. Lequesne, Pierre Decazes, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Adult, Male, lcsh:Medical physics. Medical radiology. Nuclear medicine, medicine.medical_specialty, Sarcopenia, Esophageal Neoplasms, [SDV]Life Sciences [q-bio], lcsh:R895-920, Population, Urology, Morphological change, lcsh:RC254-282, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, medicine, Humans, Chemotherapy, Radiology, Nuclear Medicine and imaging, Overall survival, education, Muscle, Skeletal, Aged, 2. Zero hunger, education.field_of_study, Univariate analysis, Radiotherapy, Proportional hazards model, business.industry, Standard treatment, Research, Oesophageal cancer, Cancer, Chemoradiotherapy, Middle Aged, medicine.disease, Prognosis, musculoskeletal system, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Concomitant, Female, business, Body mass index, human activities
Abstract: Background Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy. Methods The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h2) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability. Results Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23–40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO > 0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24–4.34], p = 0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p = 0.0002], the optimal threshold being 51.5 cm2/m2. In women, the AUC was 0.65 (p = 0.19). Conclusion Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions.
Published: 2020

5. Targeted genotyping of circulating tumor DNA for classical Hodgkin lymphoma monitoring: a prospective study

Author: J. Lequesne, Marie Cornic, Stéphane Leprêtre, Lucile Bessi, Elena-Liana Veresezan, Elodie Bohers, Justine Loret, Anne-Lise Menard, Hervé Tilly, Nathalie Contentin, Pierre-Julien Viailly, Aspasia Stamatoullas, Vincent Camus, Stéphanie Becker, Jean-Michel Picquenot, Hélène Lanic, Pierre Decazes, Sydney Dubois, Pascaline Etancelin, Pascal Lenain, Mathieu Viennot, Bénédicte Marcq, Fabrice Jardin, Emilie Lemasle, Lucie Burel, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Adult, Oncology, medicine.medical_specialty, Genotype, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Vinblastine, Article, Circulating Tumor DNA, Bleomycin, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Biomarkers, Tumor, Humans, Medicine, Hodgkin's Lymphoma, Prospective Studies, Liquid biopsy, Prospective cohort study, Genotyping, Aged, Retrospective Studies, Aged, 80 and over, Minimal Residual Disease, Chemotherapy, Cytogenetics and Molecular Genetics, business.industry, Editorials, Retrospective cohort study, Hematology, Middle Aged, Hodgkin's lymphoma, medicine.disease, Hodgkin Disease, Minimal residual disease, 3. Good health, Dacarbazine, ABVD, Doxorubicin, 030220 oncology & carcinogenesis, Mutation, business, 030215 immunology, medicine.drug
Abstract: The relevance of circulating tumor DNA (ctDNA) analysis as a liquid biopsy and minimal residual disease tool in the management of classical Hodgkin lymphoma (cHL) patients was demonstrated in retrospective settings and remains to be confirmed in a prospective setting. We developed a targeted Next-Generation sequencing (NGS) panel for fast analysis (AmpliSeq® technology) of nine commonly mutated genes in biopies and ctDNA of cHL patients. We then conducted a prospective trial to assess ctDNA follow-up at diagnosis and after two cycles (C2) of chemotherapy. Sixty cHL patients treated by first line conventional chemotherapy (BEACOPPescalated [21.3%], ABVD/ABVD-like [73.5%] and other regimens [5.2%, for elderly patients]) were assessed in this noninterventional study. The median age of the patients was 33.5 years (range: 20-86). Variants were identified in 42 (70%) patients. Mutations of NFKBIE, TNFAIP3, STAT6, PTPN1, B2M, XPO1, ITPKB, GNA13 and SOCS1 were found in 13.3%, 31.7%, 23.3%, 5%, 33.3%, 10%, 23.3%, 13.3% and 50% of patients, respectively. ctDNA concentration and genotype were correlated with clinical characteristics and presentation. Regarding early therapeutic response, 45 patients (83%, not available [NA] =6) had a negative positron emission tomography (PET) after C2 (Deauville Score 1-3). The mean of DeltaSUVmax after C2 was -78.8%. ctDNA after C2 was analysed in 54 patients (90%). ctDNA became rapidly undetectable in all cases after C2. Variant detection in ctDNA is suitable to depict the genetic features of cHL at diagnosis and may help to assess early treatment response, in association with PET. Clinical Trial reference: NCT02815137.
Published: 2020

6. « Définition des volumes cibles : quand et comment l’oncologue radiothérapeute peut-il utiliser la TEP ? »

Author: E. Texte, Romain Modzelewski, P. Gouel, D. Gensanne, Sébastien Hapdey, Sébastien Thureau, Pierre Decazes, Pierre Vera, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)
Subjects: 03 medical and health sciences, 0302 clinical medicine, Oncology, [SDV]Life Sciences [q-bio], 030220 oncology & carcinogenesis, Philosophy, Radiology, Nuclear Medicine and imaging, Humanities, 3. Good health
Abstract: Resume La TEP/tomodensitometrie est devenue un examen standard en cancerologie mais reste probablement sous-utilisee pour la planification de la radiotherapie. Pourtant en dehors des donnees de recherche clinique qui montre l’interet de cet examen pour envisager une radiotherapie personnalisee et adaptative, elle est egalement importante dans la definition des volumes cibles. Toutefois, avant de l’utiliser en pratique clinique, quelques prerequis sont indispensables pour connaitre les methodes d’acquisition et de segmentation. Idealement la TEP/tomodensitometrie doit devenir un examen standard pour les departements de radiotherapie au meme titre que la tomodensitometrie de planification l’est aujourd’hui et que l’IRM dans un avenir proche.
Published: 2019

7. Angiogenesis imaging study using interim [18F] RGD-K5 PET/CT in patients with lymphoma undergoing chemotherapy: preliminary evidence

Author: Pierre Decazes, David Tonnelet, M. D. Pierre Bohn, Fabrice Jardin, Hervé Tilly, Pierre Vera, Vincent Camus, Sébastien Thureau, Stéphanie Becker, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Lymphoma, Angiogenesis, FDG, PET/CT, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, R895-920, 030218 nuclear medicine & medical imaging, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, 18F-RGD-K5, 0302 clinical medicine, K5, Medicine, Radiology, Nuclear Medicine and imaging, In patient, education, Original Research, Fluorodeoxyglucose, PET-CT, education.field_of_study, Chemotherapy, RGD, business.industry, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, business, Nuclear medicine, medicine.drug
Abstract: Background Our aim was to measure the impact of two cycles of standard chemotherapy on tumoural neoangiogenesis by [18F] fluorine arginine-glycine-aspartic (RGD-K5) positron emission tomography–computed tomography (PET) on patients presenting with lymphoma. Nineteen patients at Rouen’s Henri Becquerel Cancer Centre were prospectively included. Fluorodeoxyglucose (FDG) and RGD-K5 PET were performed before (C0) and after (C2) two cycles of chemotherapy. End-of-treatment FDG PET was performed for final evaluation. Maximum standardised uptake value (SUVmax), SUVmean, Metabolic Tumour Volume (MTV) and Angiogenic Tumour Volume (ATV) were measured for all lesions. RGD SUVmax and SUVmean were also analysed in 13 normal organs at C0 and C2. The patient’s treatment response was considered using the Deauville score (DS) at the end of FDG PET treatment (DS 1–3 were considered responders, and 4 and 5 non-responders). Results Eighteen patients had both C0 FDG and RGD PET. Twelve patients had both C2 FDG and RGD, completed the treatment protocol and were included in end-of-treatment analysis. No statistical difference was found in RGD uptake of normal organs before and after chemotherapy for SUVmax and SUVmean. On C0 RGD, apart from classical Hodgkin lymphoma (cHL; n = 5) and grey zone lymphoma (GZL; n = 1), other lymphoma sub-types (n = 12) had low RGD uptake (p p Conclusions Our study showed significant higher initial RGD uptake in patients presenting with cHL and GZL compared to NHL. Non-responder also had higher post-chemotherapy RGD uptake compared to responders. Issues raised by RGD uptake, particularly in cHL, are yet to be explored and need to be confirmed in a larger population.
Published: 2021

8. Comparison of Hypermetabolic and Hypoxic Volumes Delineated on [18F]FDG and [18F]Fluoromisonidazole PET/CT in Non-small-cell Lung Cancer Patients

Author: Romain Modzelewski, Sébastien Hapdey, Pierre Bohn, P. Gouel, Bernard Dubray, Pierre Vera, Sébastien Thureau, Département de radiothérapie et de physique médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Positron emission tomography, Cancer Research, 18F-Fluoromisonidazole, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine, Radiology, Nuclear Medicine and imaging, Hypoxia, Lung cancer, Prospective cohort study, PET-CT, 2-deoxy-2-[18F]fluoro-D-glucose, Radiotherapy, medicine.diagnostic_test, business.industry, medicine.disease, 3. Good health, Radiation therapy, [18F]fluoromisonidasole, Oncology, 030220 oncology & carcinogenesis, Non small cell, Nuclear medicine, business, FMISO
Abstract: The high rates of failure in the radiotherapy target volume suggest that patients with stage II or III non-small-cell lung cancer (NSCLC) should receive an increased total dose of radiotherapy. 2-Deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) and [18F]fluoromisonidazole ([18F]FMISO) (hypoxia) uptake on pre-radiotherapy positron emission tomography (PET)/X-ray computed tomography (CT) have been independently reported to identify intratumor subvolumes at higher risk of relapse after radiotherapy. We have compared the [18F]FDG and [18F]FMISO volumes defined by PET/CT in NSCLC patients included in a prospective study. Thirty-four patients with non-resectable lung cancer underwent [18F]FDG and [18F]FMISO PET/CT before (pre-RT) and during radiotherapy (around 42 Gy, per-RT). The criteria were to delineate 40 % and 90 % SUVmax thresholds on [18F]FDG PET/CT (metabolic volumes), and SUV > 1.4 on pre-RT [18F]FMISO PET/CT (hypoxic volume). The functional volumes were delineated within the tumor volume as defined on co-registered CTs. The mean pre-RT and per-RT [18F]FDG volumes were not statistically different (30.4 cc vs 22.2; P = 0.12). The mean pre-RT SUVmax [18F]FDG was higher than per-RT SUVmax (12.7 vs 6.5; P
Published: 2019

9. Latent Correlation Representation Learning for Brain Tumor Segmentation with Missing MRI Modalities

Author: Pierre Vera, Stéphane Canu, Su Ruan, Tongxue Zhou, Equipe Apprentissage (DocApp - LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: FOS: Computer and information sciences, genetic structures, Computer science, [SDV]Life Sciences [q-bio], Computer Vision and Pattern Recognition (cs.CV), Computer Science - Computer Vision and Pattern Recognition, 02 engineering and technology, Multimodal Imaging, 030218 nuclear medicine & medical imaging, Correlation, 03 medical and health sciences, 0302 clinical medicine, Deep Learning, Image Interpretation, Computer-Assisted, 0202 electrical engineering, electronic engineering, information engineering, medicine, FOS: Electrical engineering, electronic engineering, information engineering, Humans, Segmentation, Modalities, Modality (human–computer interaction), medicine.diagnostic_test, business.industry, Brain Neoplasms, Image and Video Processing (eess.IV), Representation (systemics), Magnetic resonance imaging, Pattern recognition, Electrical Engineering and Systems Science - Image and Video Processing, Computer Graphics and Computer-Aided Design, Magnetic Resonance Imaging, 020201 artificial intelligence & image processing, Artificial intelligence, business, Encoder, Feature learning, Software, Algorithms
Abstract: Magnetic Resonance Imaging (MRI) is a widely used imaging technique to assess brain tumor. Accurately segmenting brain tumor from MR images is the key to clinical diagnostics and treatment planning. In addition, multi-modal MR images can provide complementary information for accurate brain tumor segmentation. However, it's common to miss some imaging modalities in clinical practice. In this paper, we present a novel brain tumor segmentation algorithm with missing modalities. Since it exists a strong correlation between multi-modalities, a correlation model is proposed to specially represent the latent multi-source correlation. Thanks to the obtained correlation representation, the segmentation becomes more robust in the case of missing modality. First, the individual representation produced by each encoder is used to estimate the modality independent parameter. Then, the correlation model transforms all the individual representations to the latent multi-source correlation representations. Finally, the correlation representations across modalities are fused via attention mechanism into a shared representation to emphasize the most important features for segmentation. We evaluate our model on BraTS 2018 and BraTS 2019 dataset, it outperforms the current state-of-the-art methods and produces robust results when one or more modalities are missing., Comment: 12 pages, 10 figures, accepted by IEEE Transactions on Image Processing (8 April 2021). arXiv admin note: text overlap with arXiv:2003.08870, arXiv:2102.03111
Published: 2021
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10. The added value of clinical radiopharmacists in nuclear medicine: The example of glomerular filtration rate assessment in kidney donors

Author: Pierre Bohn, Joseph Le Cloirec, Stéphanie Becker, Juliette Dinet, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], chemistry.chemical_element, Renal function, Technetium, Kidney, Kidney Function Tests, Pharmacists, 030226 pharmacology & pharmacy, 03 medical and health sciences, 0302 clinical medicine, Professional Role, radiopharmacy, Living Donors, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, nuclear medicine, Retrospective Studies, Pharmacology, Measurement method, business.industry, Significant difference, Retrospective cohort study, Patient exposure, Middle Aged, Kidney Transplantation, Chromium Radioisotopes, 3. Good health, Radiation exposure, medicine.anatomical_structure, chemistry, Emergency medicine, Technetium Tc 99m Pentetate, Female, Radiopharmaceuticals, business, Pharmacy Service, Hospital, Glomerular Filtration Rate
Abstract: What is known and objectives In Europe, the pharmaceutical supply of chromium-51 has been stopped. However, this isotope is necessary for the evaluation of glomerular filtration rates. It is possible to replace it with technetium-99m, but the validation of this change in the measurement method must be carried out. Methods A retrospective analysis of chromium-51 data from January 2018 to January 2019 was performed, followed by a study from January 2019 to January 2020 using the technetium tracer. The patients were different in the both study groups, and none had an eGFR below 50 mL min-1 . A cost analysis was performed. Patient exposure to ionizing radiation was studied for both methods. Results and discussion Seventy-eight patients were included in the study. In total, 42 EDTA-51 Cr and 36 DTPA-99m Tc examinations were conducted and compared. There were no significant differences between the methods used to assess renal function (P = .351). The results of cost analysis and patient radiation exposure were in favour of DTPA-99m Tc examinations. What is new and conclusion Within the limitations of a retrospective study of two patient cohorts, there was no significant difference between the results obtained with chromium-51 and technetium-99m tracers. In addition, with the use of DTPA-99m Tc, operating costs and patient exposure to ionizing radiation were reduced, and clinical activity was maintained for the patients' benefit. Radiopharmacists are able to react quickly to supply contingencies, reduce operating costs and maintain the quality of medical examinations.
Published: 2020

11. How to work together between nuclear medicine and radiotherapy departments?

Author: S. Hapdey, Pierre Vera, Romain Modzelewski, P. Gouel, Sébastien Thureau, D. Gensanne, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), service de radiothérapie et de physique médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Standardization, Treatment position, Computer science, PET/CT, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Pooling, Common support, 03 medical and health sciences, Appointments and Schedules, 0302 clinical medicine, Neoplasms, Positron Emission Tomography Computed Tomography, Terminology as Topic, medicine, Humans, Radiology, Nuclear Medicine and imaging, Staff Development, Radiothérapie, PET-CT, medicine.diagnostic_test, Radiology Department, Hospital, Radiotherapy, business.industry, Strategic Choice, Clinical routine, Prise en charge commune, 3. Good health, Functional imaging, Radiation therapy, Oncology, Positron emission tomography, 030220 oncology & carcinogenesis, Coordination, Nuclear medicine, Radiation Oncology, Interdisciplinary Communication, Position de traitement, business, TEP/TDM, Médecine nucléaire, Radiotherapy, Image-Guided
Abstract: International audience; Among the available imaging techniques, functional imaging provided by nuclear medicine departments represents a tool of choice for the oncoradiotherapist for targeting tumour activity, with positron emission tomography as the main modality. Before, during or after radiotherapy, functional imaging helps guide the oncoradiotherapist in making decisions and in the strategic choice of pathology management. Setting up a working group to ensure perfect coordination at all levels is the first step. Key points for a common and coordinated management between the two departments are the definition of an organizational logistic, training of personnel at every levels, standardization of nomenclatures, the choice of adapted and common equipment, implementation of regulatory controls, and research/clinical routine continuum. The availability of functional examinations dedicated to radiotherapy in clinical routine is possible and requires a convergence of teams and a pooling of tools and techniques.
Published: 2020

12. Correlation between fluorodeoxyglucose hotspots on preradiotherapy PET/CT and areas of cancer local relapse: Systematic review of literature

Author: D. Bourhis, Pierre-Yves Salaun, J.-C. Leclère, Ulrike Schick, François Lucia, Jeremie Calais, Ronan Abgral, Pierre Vera, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: medicine.medical_specialty, Lung Neoplasms, Esophageal Neoplasms, PET/CT, medicine.medical_treatment, [SDV]Life Sciences [q-bio], MEDLINE, Patient Positioning, Correlation, Revue de littérature, 03 medical and health sciences, 0302 clinical medicine, FDG « hotspots », Fluorodeoxyglucose F18, Neoplasms, Positron Emission Tomography Computed Tomography, medicine, Dose escalation, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, FDG hotspots, Retrospective Studies, Radiothérapie, Fluorodeoxyglucose, Literature review, PET-CT, Radiotherapy, Rectal Neoplasms, business.industry, Rechute locale, Local relapse, 3. Good health, Radiation therapy, Oncology, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Electronic database, Radiology, Tomography, Anatomic Landmarks, Neoplasm Recurrence, Local, Radiopharmaceuticals, business, TEP-TDM, medicine.drug
Abstract: International audience; The aim of the present paper is to systematically review all available literature on preradiotherapy high uptake areas (hotspots) as a potential target for dose escalation in different tumour sites, and to understand the potential role and limitations of fluorodeoxyglucose (FDG)-positron-emission tomography (PET)/computed tomography (CT) in this context. An electronic database (Medline) search was conducted to identify articles reporting on a correlation between high tracer uptake on pretreatment PET and preferential sites of local recurrence after radiotherapy. Search was limited to English language. No date range limitation was applied. Among 45 studies initially identified, nine series matching with inclusion criteria have finally been retained from the literature after reviewing (5 retrospective and 4 prospective). Primary tumour locations were head-neck (n=2), lung (n=4), oesophageal (n=2) and rectal (n=1) areas. Overlaps between FDG hotspot on preradiotherapy PET/CT and site of local recurrence on post-treatment scan showed good to excellent agreement. Only studies on head-neck cancer reported moderate agreement probably explained by the lack of reproducibility of the patients positioning between pre- and post-treatment FDG-PET/CT; and by the rigid registration process of images limited by post-therapeutic changes that highly affect anatomical landmarks. FDG hotspot-guided radiotherapy may allow dose escalation in respecting a robust methodology (treatment position, co-registration method, four-dimensional PET).
Published: 2020

13. Positron-emission tomography-guided radiation therapy: Ongoing projects and future hopes

Author: D. Tonnelet, N. Giraud, H. Regaieg, Pierre Vera, G. Popinat, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Glutamate Carboxypeptidase II, Male, Lung Neoplasms, Esophageal Neoplasms, Lymphoma, Nuclear imaging, Computer science, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Clinical oncology, Radiation oncology, Antineoplastic Agents, Immunological, 0302 clinical medicine, Neoplasms, Positron Emission Tomography Computed Tomography, Image-guided radiation therapy, Radiation oncologist, medicine.diagnostic_test, Brain Neoplasms, Antibodies, Monoclonal, Sarcoma, Magnetic Resonance Imaging, 3. Good health, Oncology, Head and Neck Neoplasms, Positron emission tomography, 030220 oncology & carcinogenesis, Antigens, Surface, Functional imaging, After treatment, medicine.medical_specialty, Antibodies, Monoclonal, Humanized, Imagerie fonctionnelle, Radiothérapie guidée par l’image, 03 medical and health sciences, medicine, Humans, Radiology, Nuclear Medicine and imaging, Medical physics, Radiothérapie, Oncologie clinique, Rectal Neoplasms, Prostatic Neoplasms, Radiation therapy, Particle Accelerators, Radiopharmaceuticals, Forecasting, Radiotherapy, Image-Guided
Abstract: International audience; Radiation therapy has undergone significant advances these last decades, particularly thanks to technical improvements, computer science and a better ability to define the target volumes via morphological and functional imaging breakthroughs. Imaging contributes to all three stages of patient care in radiation oncology: before, during and after treatment. Before the treatment, the choice of optimal imaging type and, if necessary, the adequate functional tracer will allow a better definition of the volume target. During radiation therapy, image-guidance aims at locating the tumour target and tailoring the volume target to anatomical and tumoral variations. Imaging systems are now integrated with conventional accelerators, and newer accelerators have techniques allowing tumour tracking during the irradiation. More recently, MRI-guided systems have been developed, and are already active in a few French centres. Finally, after radiotherapy, imaging plays a major role in most patients' monitoring, and must take into account post-radiation tissue modification specificities. In this review, we will focus on the ongoing projects of nuclear imaging in oncology, and how they can help the radiation oncologist to better treat patients. To this end, a literature review including the terms "Radiotherapy", "Radiation Oncology" and "PET-CT" was performed in August 2019 on Medline and ClinicalTrials.gov. We chose to review successively these novelties organ-by-organ, focusing on the most promising advances. As a conclusion, the help of modern functional imaging thanks to a better definition and new specific radiopharmaceuticals tracers could allow even more precise treatments and enhanced surveillance. Finally, it could provide determinant information to artificial intelligence algorithms in "-omics" models.
Published: 2020

14. Methods to delineate tumour for radiotherapy by fluorodeoxyglucose positron emission tomography

Author: Isabelle Gardin, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Metabolic tumour volume, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Context (language use), Computed tomography, Fluorodeoxyglucose positron emission tomography, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Délinéation, Neoplasms, Positron Emission Tomography Computed Tomography, medicine, Humans, Radiology, Nuclear Medicine and imaging, Volume tumoral métabolique, medicine.diagnostic_test, business.industry, Delineation, TEP FDG, 3. Good health, Radiation therapy, Oncology, 030220 oncology & carcinogenesis, FDG PET, Tumour volume, Radiopharmaceuticals, business, Nuclear medicine, Algorithms
Abstract: International audience; Numerous articles have been published showing the interest to delineate tumours using fluorodeoxyglucose positron emission tomography/computed tomography images in radiotherapy planning. This imaging is used to identify tumour tissues with increased glucose metabolism compared to healthy surrounding tissues. This volume corresponds to the metabolic tumour volume. Despite extensive research on metabolic tumour volume segmentation methods, there is currently no consensus on the optimal segmentation method to use. In this review, the main methods proposed in the literature are presented, as well as their advantages and disadvantages in the context of radiotherapy.
Published: 2020

15. Correlation Between FDG Hotspots on Pre-radiotherapy PET/CT and Areas of HNSCC Local Relapse: Impact of Treatment Position and Images Registration Method

Author: Blandine Truffault, David Bourhis, Anne Chaput, Jeremie Calais, Philippe Robin, Romain Le Pennec, François Lucia, Jean-Christophe Leclère, Dorothy M. Gujral, Pierre Vera, Pierre-Yves Salaün, Ulrike Schick, Ronan Abgral, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: [SDV]Life Sciences [q-bio], medicine.medical_treatment, HNSCC, 030218 nuclear medicine & medical imaging, Correlation, 03 medical and health sciences, Rare Diseases, 0302 clinical medicine, Clinical Research, medicine, Dose escalation, Dental/Oral and Craniofacial Disease, FDG-PET, Cancer, Original Research, FDG-PET/CT hotspots, lcsh:R5-920, screening and diagnosis, PET-CT, business.industry, local relapse, Retrospective cohort study, General Medicine, CT hotspots, medicine.disease, Head and neck squamous-cell carcinoma, 3. Good health, Radiation therapy, Detection, radiotherapy treatment position, 030220 oncology & carcinogenesis, Biomedical Imaging, Medicine, Tomography, images registration, lcsh:Medicine (General), business, Nuclear medicine, 4.2 Evaluation of markers and technologies
Abstract: International audience; Aim: Several series have already demonstrated that intratumoral subvolumes with high tracer avidity (hotspots) in 18F-flurodesoxyglucose positron-emission tomography (FDG-PET/CT) are preferential sites of local recurrence (LR) in various solid cancers after radiotherapy (RT), becoming potential targets for dose escalation. However, studies conducted on head and neck squamous cell carcinoma (HNSCC) found only a moderate overlap between pre- and post-treatment subvolumes. A limitation of these studies was that scans were not performed in RT treatment position (TP) and were coregistred using a rigid registration (RR) method. We sought to study (i) the influence of FDG-PET/CT acquisition in TP and (ii) the impact of using an elastic registration (ER) method to improve the localization of hotpots in HNSCC. Methods: Consecutive patients with HNSCC treated by RT between March 2015 and September 2017 who underwent FDG-PET/CT in TP at initial staging (PETA) and during follow-up (PETR) were prospectively included. We utilized a control group scanned in non treatment position (NTP) from our previous retrospective study. Scans were registered with both RR and ER methods. Various sub-volumes (AX; x = 30, 40, 50, 60, 70, 80, and 90%SUVmax) within the initial tumor and in the subsequent LR (RX; x = 40 and 70%SUVmax) were overlaid on the initial PET/CT for comparison [Dice, Jaccard, overlap fraction = OF, common volume/baseline volume = AXnRX/AX, common volume/recurrent volume = AXnRX/RX]. Results: Of 199 patients included, 43 (21.6%) had LR (TP = 15; NTP = 28). The overlap between A30, A40, and A50 sub-volumes on PETA and the whole metabolic volume of recurrence R40 and R70 on PETR showed moderate to good agreements (0.41-0.64) with OF and AXnRX/RX index, regardless of registration method or patient position. Comparison of registration method demonstrated OF and AXnRX/RX indices (x = 30% to 50%SUVmax) were significantly higher with ER vs. RR in NTP (p < 0.03), but not in TP. For patient position, the OF and AXnRX/RX indices were higher in TP than in NTP when RR was used with a trend toward significance, particularly for x=40%SUVmax (0.50±0.22 vs. 0.31 ± 0.13, p = 0.094). Conclusion: Our study suggested that PET/CT acquired in TP improves results in the localization of FDG hotspots in HNSCC. If TP is not possible, using an ER method is significantly more accurate than RR for overlap estimation.
Published: 2020

16. Bevacizumab and platinum-based combinations for recurrent ovarian cancer: a randomised, open-label, phase 3 trial

Author: Jacobus Pfisterer, Catherine M Shannon, Klaus Baumann, Joern Rau, Philipp Harter, Florence Joly, Jalid Sehouli, Ulrich Canzler, Barbara Schmalfeldt, Andrew P Dean, Alexander Hein, Alain G Zeimet, Lars C Hanker, Thierry Petit, Frederik Marmé, Ahmed El-Balat, Rosalind Glasspool, Nikolaus de Gregorio, Sven Mahner, Tarek M Meniawy, Tjoung-Won Park-Simon, Marie-Ange Mouret-Reynier, Cristina Costan, Werner Meier, Alexander Reinthaller, Jeffrey C Goh, Tifenn L'Haridon, Sally Baron Hay, Stefan Kommoss, Andreas du Bois, Jean-Emmanuel Kurtz, Sven Ackermann, Christoph Anthuber, Mustafa Aydogdu, Angelika Baldauf, Wolfgang Bauer, Dirk Behringer, Antje Belau, Alexandra Bender, Cosima Brucker, Alexander Burges, Trygve Daabach, Dominik Denschlag, Mustafa Deryal, Steffen Dörfel, Juliane Ebert, Tanja Fehm, Susanne Maria Feidicker, Gabriele Feisel-Schwickardi, Ricardo Felberbaum, Matthias Frank, Gerhard Gebauer, Bernd Gerber, Axel Gerhardt, Andrea Grafe, Martin Griesshammer, Eva-Maria Grischke, Isolde Gröll, Martina Gropp-Meier, Dietrich Hager, Volker Hanf, Carla Verena Hannig, Peer Hantschmann, Tanja Hauzenberger, Uwe Herwig, Martin Heubner, Carsten Hielscher, Felix Hilpert, Thomas Hitschold, Manfred Hofmann, Christian Jackisch, Wolfgang Janni, Ludwig Kiesel, Yon-Dschun Ko, Hans-Joachim Koch, Petra Krabisch, Peter Krieger, Thomas Kubin, Thorsten Kühn, Björn Lampe, Peter Ledwon, Sabine Lemster, Benno Lex, Clemens Liebrich, Ralf Lorenz, Hans-Joachim Lück, Peter Mallmann, Wolfgang Meinerz, Götz Menke, Volker Möbus, Thomas Müller, Volker Müller, Tanja Neunhöffer, Angelika Ober, Gülten Oskay-Özcelik, Horst Ostertag, Martin Pölcher, Beate Rautenberg, Daniel Rein, Wilhelm Reiter, Andreas Rempen, Ingo Runnebaum, Marcus Schmidt, Sabine Schnohr, Heinz Scholz, Willibald Schröder, Eike Simon, Antje Sperfeld, Annette Steckkönig, Hans-Georg Strauß, Ronaldo Stuth, Jürgen Terhaag, Falk Thiel, Marc Thill, Oliver Tomé, Christoph Uleer, Susanne Vogel, Hermann Voß, Michael Weigel, Ulrich Winkler, Arthur Wischnik, Tobias Zeiser, Andreas Zorr, Ros Glasspool, Emma Hudson, Rachel Jones, Judith Lafleur, Christian Marth, Edgar Petru, Yoland Antill, Mary Azer, Sally Baron-Hay, Philip Beale, Stephen Begbie, Allison Black, Karen Briscoe, Andrew Dean, Jeffrey Goh, Sandra Harvey, Chee Lee, Marco Matos, Tarek Meniawy, Inger Olesen, Catherine Shannon, Paul Vasey, Sophie Abadie-Lacourtoisie, Olivier Arsene, Sophie Barthier, Célia Becuwe-Roemer, Dominique Berton-Rigaud, Maria Cappiello-Bataller, Stéphanie Catala, Francesco Del Piano, Gaël Deplanque, Raymond Despax, Nadine Dohollou, Claire Garnier-Tixidré, Julien Grenier, Emmanuel Guardiola, Anne-Claire Hardy-Bessard, Claudia Lefeuvre-Plesse, Marianne Leheurteur, Anne Lesoin, Charles-Briac Levache, Raffaele Longo, Alain Lortholary, Jérôme Meunier, Nadia Raban, Olivier Romano, Jean-Michel Vannetzel, Alain Zannetti, Cancers et préventions, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Obstetrics and Gynecology, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Department of OB/Gyn, University Breast Center Franconia, Univeristy Hospital Erlangen, Goethe-Universität Frankfurt am Main, Mines Nantes (Mines Nantes), Division Molecular Biology of Breast Cancer, Department of Gynecology and Obstetrics, Universität Heidelberg [Heidelberg] = Heidelberg University, Department of Gynecology, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Hannover Medical School [Hannover] (MHH), Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Medizinische Universität Wien = Medical University of Vienna, Les Hôpitaux Universitaires de Strasbourg (HUS), Department of Gynaecology, Universität Greifswald - University of Greifswald, University Hospital Düsseldorf, Eberhard Karls Universität Tübingen = Eberhard Karls University of Tuebingen, University of Rostock, Städtische Kliniken, Department of Gynecology and Obstetrics, Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Hämatologie/Onkologie, Klinikum Traunstein, Department of OB/Gyn, Hospital Bayreuth, École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Department of Gynecology and Obstetrics, Center for Integrated Oncology, Bonn University Medical Center, University Hospital Bonn, Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany], Chemical Metals Science Department, Max Planck Institute for Chemical Physics of Solids (CPfS), Max-Planck-Gesellschaft-Max-Planck-Gesellschaft, Leopold Franzens Universität Innsbruck - University of Innsbruck, Fred Hutchinson Cancer Research Center [Seattle] (FHCRC), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Centre Hospitalier de Blois (CHB), CRLCC René Gauducheau, Hôpital Saint-Joseph [Marseille], Polyclinique Bordeaux Nord Aquitaine (PBNA), Toxicité environnementale, cibles thérapeutiques, signalisation cellulaire (T3S - UMR_S 1124), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Armoricain de Radiothérapie, d'Imagerie médicale et d'Oncologie [Plérin, Saint-Brieuc] (CARIO), Department of Medical Oncology, CRLCC Eugène Marquis (CRLCC), Service d'Oncologie Médicale, CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Polyclinique Francheville, Centre Catherine-de-Sienne [Nantes] (CCS), Centre Hospitalier Régional d'Orléans (CHRO), Hématologie clinique [CH Cholet], CH Cholet, Universität Heidelberg [Heidelberg], Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Tübingen [Germany], HESAM Université (HESAM)-HESAM Université (HESAM), University Hospital of Bonn, University of Innsbruck, Centre Hospitalier de Blois (CH Blois), Polyclinique Bordeaux Nord Aquitaine, Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Lille Nord de France (COMUE)-UNICANCER
Subjects: 0301 basic medicine, genetic structures, endocrine system diseases, [SDV]Life Sciences [q-bio], Gastroenterology, law.invention, Carboplatin, Polyethylene Glycols, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, Antineoplastic Combined Chemotherapy Protocols, Clinical endpoint, Ovarian Neoplasms, education.field_of_study, Standard treatment, Middle Aged, female genital diseases and pregnancy complications, 3. Good health, Bevacizumab, Oncology, Response Evaluation Criteria in Solid Tumors, 030220 oncology & carcinogenesis, Austria, Female, France, medicine.drug, Adult, medicine.medical_specialty, Paclitaxel, Population, 03 medical and health sciences, Internal medicine, medicine, Fallopian Tube Neoplasms, Humans, education, Aged, Platinum, business.industry, Australia, eye diseases, Regimen, 030104 developmental biology, chemistry, Doxorubicin, sense organs, Neoplasm Recurrence, Local, business
Abstract: Background:\ud State-of-the art therapy for recurrent ovarian cancer suitable for platinum-based re-treatment includes bevacizumab-containing combinations (eg, bevacizumab combined with carboplatin–paclitaxel or carboplatin–gemcitabine) or the most active non-bevacizumab regimen: carboplatin–pegylated liposomal doxorubicin. The aim of this head-to-head trial was to compare a standard bevacizumab-containing regimen versus carboplatin–pegylated liposomal doxorubicin combined with bevacizumab.\ud Methods:\ud This multicentre, open-label, randomised, phase 3 trial, was done in 159 academic centres in Germany, France, Australia, Austria, and the UK. Eligible patients (aged ≥18 years) had histologically confirmed epithelial ovarian, primary peritoneal, or fallopian tube carcinoma with first disease recurrence more than 6 months after first-line platinum-based chemotherapy, and an Eastern Cooperative Oncology Group performance status of 0–2. Patients were stratified by platinum-free interval, residual tumour, previous antiangiogenic therapy, and study group language, and were centrally randomly assigned 1:1 using randomly permuted blocks of size two, four, or six to receive six intravenous cycles of bevacizumab (15 mg/kg, day 1) plus carboplatin (area under the concentration curve [AUC] 4, day 1) plus gemcitabine (1000 mg/m 2, days 1 and 8) every 3 weeks or six cycles of bevacizumab (10 mg/kg, days 1 and 15) plus carboplatin (AUC 5, day 1) plus pegylated liposomal doxorubicin (30 mg/m 2, day 1) every 4 weeks, both followed by maintenance bevacizumab (15 mg/kg every 3 weeks in both groups) until disease progression or unacceptable toxicity. There was no masking in this open-label trial. The primary endpoint was investigator-assessed progression-free survival according to Response Evaluation Criteria in Solid Tumors version 1.1. Efficacy data were analysed in the intention-to-treat population. Safety was analysed in all patients who received at least one dose of study drug. This completed study is registered with ClinicalTrials.gov, NCT01837251.\ud Findings:\ud Between Aug 1, 2013, and July 31, 2015, 682 eligible patients were enrolled, of whom 345 were randomly assigned to receive carboplatin–pegylated liposomal doxorubicin–bevacizumab (experimental group) and 337 were randomly assigned to receive carboplatin–gemcitabine–bevacizumab (standard group). Median follow-up for progression-free survival at data cutoff (July 10, 2018) was 12·4 months (IQR 8·3–21·7) in the experimental group and 11·3 months (8·0–18·4) in the standard group. Median progression-free survival was 13·3 months (95% CI 11·7–14·2) in the experimental group versus 11·6 months (11·0–12·7) in the standard group (hazard ratio 0·81, 95% CI 0·68–0·96; p=0·012). The most common grade 3 or 4 adverse events were hypertension (88 [27%] of 332 patients in the experimental group vs 67 [20%] of 329 patients in the standard group) and neutropenia (40 [12%] vs 73 [22%]). Serious adverse events occurred in 33 (10%) of 332 patients in the experimental group and 28 (9%) of 329 in the standard group. Treatment-related deaths occurred in one patient in the experimental group (
Published: 2020

17. Lymphoma Segmentation in PET Images Based on Multi-view and Conv3D Fusion Strategy

Author: Pierre Vera, Pierre Decazes, Su Ruan, Tongxue Zhou, Haigen Hu, Leizhao Shen, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Fusion, Computer science, business.industry, [SDV]Life Sciences [q-bio], Pattern recognition, 02 engineering and technology, 030218 nuclear medicine & medical imaging, Image (mathematics), 03 medical and health sciences, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, 020201 artificial intelligence & image processing, Segmentation, Artificial intelligence, business, ComputingMilieux_MISCELLANEOUS, Network model
Abstract: Due to the poor image information of lymphoma in PET images, it is still a challenge to segment them correctly. In this work, a fusion strategy by 2D multi-view and 3D networks is proposed to take full advantage of available information for segmentation. Firstly, we train three 2D network models from three orthogonal views based on 2D ResUnet, and train a 3D network model by using volumetric data based on 3D ResUnet. Then the obtained preliminary results (three 2D results and one 3D result) are fused by combing the original volumetric data based on a Conv3D fusion strategy. Finally, a series experiments are conducted on lymphoma dataset, and the results show that the proposed multi-view lymphoma co-segmentation scheme is promising, and it can improve the comprehensive performance by combing 2D multi-view and 3D networks.
Published: 2020

18. Deep disentangled representation learning of pet images for lymphoma outcome prediction

Author: Su Ruan, Yu Guo, Hua Li, Pierre Decazes, Stéphanie Becker, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Modality (human–computer interaction), Computer science, business.industry, [SDV]Life Sciences [q-bio], Feature extraction, Pattern recognition, Iterative reconstruction, 030218 nuclear medicine & medical imaging, Image (mathematics), 03 medical and health sciences, 0302 clinical medicine, Feature (computer vision), 030220 oncology & carcinogenesis, Artificial intelligence, Outcome prediction, business, Feature learning, ComputingMilieux_MISCELLANEOUS
Abstract: Image feature extraction based on deep disentangled representation learning of PET images is proposed for the prediction of lymphoma treatment response. Our method encodes PET images as spatial representations and modality representations by performing supervised tumor segmentation and image reconstruction. In this way, the whole image features (global features) as well as tumor region features (local features) can be extracted without the labor-intensive tumor segmentation and feature calculation procedure. The learned global and local image features are then joined with several prognostic factors evaluated by physicians based on clinical information, and used as input of a SVM classifier for predicting outcome results of lymphoma patients. In this study, 186 lymphoma patient data were included for training and testing the proposed model. The proposed method was compared with the traditional straightforward feature extraction method. The better prediction results of the proposed method also show its efficiency for prognostic prediction related feature extraction in PET images.
Published: 2020

19. Contemporary outcomes of metastatic breast cancer among 22,000 women from the multicentre ESME cohort 2008–2016

Author: Laurence Vanlemmens, Marc Debled, Magali Lacroix-Triki, Christelle Levy, David Pérol, Lionel Uwer, Elise Deluche, Véronique Diéras, Thierry Petit, Veronique Lorgis, Thomas Bachelot, Simone Mathoulin-Pélissier, Anne Patsouris, Mathieu Robain, Jean Marc Ferrero, Marie Ange Mouret-Reynier, C. Courtinard, Florence Dalenc, Etienne Brain, Alison Antoine, C. Lefeuvre-Plesse, Marianne Leheurteur, Christelle Jouannaud, William Jacot, Anthony Gonçalves, Suzette Delaloge, Audrey Lardy-Cleaud, CHU Limoges, Oncogénèse et progression tumorale, Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Léon Bérard [Lyon], Medical Oncology Department, Salah Azaiz Institute, Department of Medical Oncology [Saint-Cloud], Institut Curie [Saint-Cloud], Service d'Oncologie Médicale, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Institut Claudius Regaud, Senescence Escape and Soluble Markers of Cancer Progression (CRCINA-ÉQUIPE 12), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Service d'Oncologie médicale [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Department of Medical Oncology, CRLCC Eugène Marquis (CRLCC), Plateforme de génétique moléculaire des cancers d'Aquitaine, Centre Paul Strauss, CRLCC Paul Strauss, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Département de Biologie et de Pathologie, Department of Biostatistics, Institut Curie [Paris], Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), and Université de Lille-UNICANCER
Subjects: 0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Real life, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, 0302 clinical medicine, Medical economics, Internal medicine, HER2, Epidemiology, Overall survival, medicine, skin and connective tissue diseases, Observational database, Subtypes, business.industry, Cancer, medicine.disease, Metastatic breast cancer, Confidence interval, 3. Good health, 030104 developmental biology, 030220 oncology & carcinogenesis, Cohort, business
Abstract: Aim Real-world data inform the outcome comparisons and help the development of new therapeutic strategies. To this end, we aimed to describe the full characteristics and outcomes in the Epidemiological Strategy and Medical Economics (ESME) cohort, a large national contemporary observational database of patients with metastatic breast cancer (MBC). Methods Women aged ≥18 years with newly diagnosed MBC and who initiated MBC treatment between January 2008 and December 2016 in one of the 18 French Comprehensive Cancer Centers (N = 22,109) were included. We assessed the full patients’ characteristics, first-line treatments, overall survival (OS) and first-line progression-free survival, as well as updated prognostic factors in the whole cohort and among the 3 major subtypes: hormone receptor positive and HER2-negative (HR+/HER2−, n = 13,656), HER2-positive (HER2+, n = 4017) and triple-negative (n = 2963) tumours. Results The median OS of the whole cohort was 39.5 months (95% confidence interval [CI], 38.7–40.3). Five-year OS was 33.8%. OS differed significantly between the 3 subtypes (p Conclusions The ESME program represents a unique large-scale real-life cohort on MBC. This study highlights important situations of high medical need within MBC patients. Database registration clinicaltrials.gov Identifier NCT032753.
Published: 2020

20. Development of Novel 111-In-Labelled DOTA Urotensin II Analogues for Targeting the UT Receptor Overexpressed in Solid Tumours

Author: Martin Pedard, Marc-André Bonin, Richard Leduc, Martine Dubois, Pierre Vera, Fabrice Morin, Hélène Castel, Pierrick Gandolfo, Laurence Desrues, Romain Modzelewski, Pierre Decazes, Pierre Bohn, Benjamin Poret, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: [SDV]Life Sciences [q-bio], lcsh:QR1-502, Context (language use), carcinoma, Biochemistry, lcsh:Microbiology, radiolabelling, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, In vivo, Radioligand, DOTA, Receptor, Molecular Biology, neoplasms, A549 cell, 111Indium-DOTA-peptide analogues, 111indium-dota-peptide analogues, Ligand (biochemistry), urotensin II, 3. Good health, UT receptor, chemistry, 030220 oncology & carcinogenesis, Cancer research, Urotensin-II
Abstract: Overexpression of G protein-coupled receptors (GPCRs) in tumours is widely used to develop GPCR-targeting radioligands for solid tumour imaging in the context of diagnosis and even treatment. The human vasoactive neuropeptide urotensin II (hUII), which shares structural analogies with somatostatin, interacts with a single high affinity GPCR named UT. High expression of UT has been reported in several types of human solid tumours from lung, gut, prostate, or breast, suggesting that UT is a valuable novel target to design radiolabelled hUII analogues for cancer diagnosis. In this study, two original urotensinergic analogues were first conjugated to a DOTA chelator via an aminohexanoic acid (Ahx) hydrocarbon linker and then -hUII and DOTA-urantide, complexed to the radioactive metal indium isotope to successfully lead to radiolabelled DOTA-Ahx-hUII and DOTA-Ahx-urantide. The 111In-DOTA-hUII in human plasma revealed that only 30% of the radioligand was degraded after a 3-h period. DOTA-hUII and DOTA-urantide exhibited similar binding affinities as native peptides and relayed calcium mobilization in HEK293 cells expressing recombinant human UT. DOTA-hUII, not DOTA-urantide, was able to promote UT internalization in UT-expressing HEK293 cells, thus indicating that radiolabelled 111In-DOTA-hUII would allow sufficient retention of radioactivity within tumour cells or radiolabelled DOTA-urantide may lead to a persistent binding on UT at the plasma membrane. The potential of these radioligands as candidates to target UT was investigated in adenocarcinoma. We showed that hUII stimulated the migration and proliferation of both human lung A549 and colorectal DLD-1 adenocarcinoma cell lines endogenously expressing UT. In vivo intravenous injection of 111In-DOTA-hUII in C57BL/6 mice revealed modest organ signals, with important retention in kidney. 111In-DOTA-hUII or 111In-DOTA-urantide were also injected in nude mice bearing heterotopic xenografts of lung A549 cells or colorectal DLD-1 cells both expressing UT. The observed significant renal uptake and low tumour/muscle ratio (around 2.5) suggest fast tracer clearance from the organism. Together, DOTA-hUII and DOTA-urantide were successfully radiolabelled with 111Indium, the first one functioning as a UT agonist and the second one as a UT-biased ligand/antagonist. To allow tumour-specific targeting and prolong body distribution in preclinical models bearing some solid tumours, these radiolabelled urotensinergic analogues should be optimized for being used as potential molecular tools for diagnosis imaging or even treatment tools.
Published: 2020

21. Immunotherapy by Immune Checkpoint Inhibitors and Nuclear Medicine Imaging: Current and Future Applications

Author: Pierre Decazes, Pierre Bohn, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Cancer Research, medicine.medical_specialty, positron emission tomography, diagnostic imaging, medicine.medical_treatment, Immune checkpoint inhibitors, [SDV]Life Sciences [q-bio], Adoptive, radioactive tracers, Review, CD8-Positive T-Lymphocytes, lcsh:RC254-282, programmed cell death 1 receptor, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Nuclear medicine imaging, Medical imaging, medicine, Medical physics, CTLA-4 Antigen, Medical diagnosis, Pseudoprogression, radionuclide imaging, medicine.diagnostic_test, business.industry, Cancer, Immunotherapy, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, 3. Good health, Oncology, Positron emission tomography, 030220 oncology & carcinogenesis, business
Abstract: Immunotherapy by using immune checkpoint inhibitors is a revolutionary development in oncology. Medical imaging is also impacted by this new therapy, particularly nuclear medicine imaging (also called radionuclide imaging), which uses radioactive tracers to visualize metabolic functions. Our aim was to review the current applications of nuclear medicine imaging in immunotherapy, along with their limitations, and the perspectives offered by this imaging modality. Method: Articles describing the use of radionuclide imaging in immunotherapy were researched using PubMed by April 2019 and analyzed. Results: More than 5000 articles were analyzed, and nearly 100 of them were retained. Radionuclide imaging, notably 18F-FDG PET/CT, already has a major role in many cancers for pre-therapeutic and therapeutic evaluation, diagnoses of adverse effects, called immune-related adverse events (IrAE), and end-of-treatment evaluations. However, these current applications can be hindered by immunotherapy, notably due to atypical response patterns such as pseudoprogression, which is defined as an increase in the size of lesions, or the visualization of new lesions, followed by a response, and hyperprogression, which is an accelerated tumor growth rate after starting treatment. To overcome these difficulties, new opportunities are offered, particularly therapeutic evaluation criteria adapted to immunotherapy and immuno-PET allowing us to predict responses to immunotherapy. Moreover, some new technological solutions are also promising, such as radiomic analyses and body composition on associated anatomical images. However, more research has to be done, notably for the diagnosis of hyperprogression and pseudoprogression. Conclusion: Immunotherapy, by its major impact on cancer and by the new patterns generated on images, is revolutionary in the field of medical images. Nuclear medicine imaging is already established and will be able to help meet new challenges through its plasticity.
Published: 2020

22. Benefits of positron emission tomography scans for the evaluation of radiotherapy

Author: Pierre Vera, Pierre Decazes, Romain Modzelewski, Pierre Bohn, M. Damilleville-Martin, Sébastien Thureau, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Male, Positron emission tomography, medicine.medical_specialty, Palliative care, Lung Neoplasms, Monitoring, Therapeutic response, Esophageal Neoplasms, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Suivi, Uterine Cervical Neoplasms, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Fluorodeoxyglucose F18, Neoplasms, Positron Emission Tomography Computed Tomography, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Radiothérapie, Réponse thérapeutique, Fluorodeoxyglucose, Cervical cancer, Radiotherapy, medicine.diagnostic_test, business.industry, Rectal Neoplasms, Cancer, Prostatic Neoplasms, Chemoradiotherapy, medicine.disease, Tomographie par émission de positons, 3. Good health, Radiation therapy, Treatment Outcome, Oncology, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, Radiotherapy, Adjuvant, Radiology, Radiopharmaceuticals, business, medicine.drug
Abstract: International audience; The assessment of tumour response during and after radiotherapy determines the subsequent management of patients (adaptation of treatment plan, monitoring, adjuvant treatment, rescue treatment or palliative care). In addition to its role in extension assessment and therapeutic planning, positron emission tomography combined with computed tomography provides useful functional information for the evaluation of tumour response. The objective of this article is to review published data on positron emission tomography combined with computed tomography as a tool for evaluating external radiotherapy for cancers. Data on positron emission tomography combined with computed tomography scans acquired at different times (during, after initial and after definitive [chemo-]radiotherapy, during post-treatment follow-up) in solid tumours (lung, head and neck, cervix, oesophagus, prostate and rectum) were collected and analysed. Recent recommendations of the National Comprehensive Cancer Network are also reported. Positron emission tomography combined with computed tomography with (18F)-labelled fluorodeoxyglucose has a well-established role in clinical routine after chemoradiotherapy for locally advanced head and neck cancers, particularly to limit the number of neck lymph node dissection. This imaging modality also has a place for the evaluation of initial chemoradiotherapy of oesophageal cancer, including the detection of distant metastases, and for the post-therapeutic evaluation of cervical cancer. Several radiotracers for positron emission tomography combined with computed tomography, such as choline, are also recommended for patients with prostate cancer with biochemical failure. (18F)-fluorodeoxyglucose positron emission tomography combined with computed tomography is optional in many other circumstances and its clinical benefits, possibly in combination with MRI, to assess response to radiotherapy remain a very active area of research.
Published: 2020

23. Interest of positron-emission tomography and magnetic resonance imaging for radiotherapy planning and control

Author: Pierre Decazes, D. Gensanne, Gilles Créhange, M. Soussan, Sébastien Thureau, Juliette Thariat, service de radiothérapie et de physique médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: medicine.medical_treatment, [SDV]Life Sciences [q-bio], Planning target volume, Image registration, Multimodal Imaging, 03 medical and health sciences, 0302 clinical medicine, Positron, TEP/IRM, Neoplasms, medicine, Proton Therapy, Humans, Radiology, Nuclear Medicine and imaging, Radiation treatment planning, Proton therapy, Radiothérapie, MRI linac, medicine.diagnostic_test, Radiotherapy, business.industry, Radiotherapy Planning, Computer-Assisted, Magnetic resonance imaging, Magnetic Resonance Imaging, 3. Good health, Radiation therapy, PET, PET/MRI, TEP, Oncology, Positron emission tomography, 030220 oncology & carcinogenesis, Positron-Emission Tomography, IRM linac, business, Nuclear medicine, IRM, MRI
Abstract: International audience; Computed tomography (CT) in the treatment position is currently indispensable for planning radiation therapy. Other imaging modalities, such as magnetic resonance imaging (MRI) and positron emission-tomography (PET), can be used to improve the definition of the tumour and/or healthy tissue but also to provide functional data of the target volume. Accurate image registration is essential for treatment planning, so MRI and PET scans should be registered at the planning CT scan. Hybrid PET/MRI scans with a hard plane can be used but pose the problem of the absence of CT scans. Finally, techniques for moving the patient on a rigid air-cushioned table allow PET/CT/MRI scans to be performed in the treatment position while limiting the patient's movements exist. At the same time, the advent of MRI-linear accelerator systems allows to redefine image-guided radiotherapy and to propose treatments with daily recalculation of the dose. The place of PET during treatment remains more confidential and currently only in research and prototype status. The same development of imaging during radiotherapy is underway in proton therapy.
Published: 2020

24. Respiratory gated multistatic PET reconstructions to delineate radiotherapy target volume in patients with mobile lung tumours

Author: Pierre Vera, Agathe Edet-Sanson, Sébastien Hapdey, Anne-Charlotte Bouyeure-Petit, Bernard Dubray, Mathieu Chastan, Stéphanie Becker, P. Gouel, Sébastien Thureau, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Département de radiothérapie et de physique médicale, and Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Lung Neoplasms, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Planning target volume, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Humans, Medicine, Radiology, Nuclear Medicine and imaging, In patient, Four-Dimensional Computed Tomography, Respiratory system, Lung, business.industry, Reconstruction algorithm, Radiation therapy, medicine.anatomical_structure, Positron-Emission Tomography, 030220 oncology & carcinogenesis, Acquisition time, Lung tumours, business, Nuclear medicine
Abstract: Background PET-CT with 18F-FDG or other radiopharmaceuticals is a recommended tool to help the delineation of lung cancers candidate to radiotherapy. The motion artifacts caused by respiratory movements are reduced by 4D acquisitions. We introduced an extended reconstruction algorithm (Multiple Reconstruct Register and Average: Multi-RRA) which requires much shorter acquisition times than standard 4D PET-CT. Our aim was to evaluate the interest on multi-RRA images as an alternative of 3D and 4D PET-CT for the delineation of lung lesion. Methods PET acquisitions synchronized to the respiratory signal were obtained in 18 patients with mobile lung tumors. We compared the tumor volumes delineated on Multi-RRA images to 3D and 4D PET-CT, considering the 4D CT as a reference. The tumor volumes were delineated and compared with topologic similarity indexes (Dice, Jaccard and Overlap). Results 20 tumors were delineated. The volumes delineated with multi-RRA and 4D PET were not significantly different (mean difference of 0.2 ± 0.7mL). Comparison by pairs (Tukey- Kramer test) showed that 3D-PET volumes were significantly smaller than 4D-PET and multi- RRA volumes (p Conclusions The tumor volumes delineated on multi-RRA are similar to the volumes obtained with 4D PET, with shorter acquisition time.
Published: 2020

25. Treatment and outcomes in patients with central nervous system metastases from breast cancer in the real-life ESME MBC cohort

Author: Christelle Jouannaud, David Pasquier, Guillaume Louvel, Jean Marc Ferrero, William Jacot, Jean Sébastien Fresnel, Paule Augereau, Thierry Petit, Marianne Leheurteur, Thomas Bachelot, Jean-David Fumet, Julien Geffrelot, Florence Dalenc, Elise Deluche, Anthony Gonçalves, Paul Cottu, Véronique Diéras, Raphaëlle Mouttet-Audouard, Marie Ange Mouret-Reynier, Julien Fraisse, C. Courtinard, Lionel Uwer, I. Lecouillard, Amélie Darlix, Adeline Petit, Mathieu Robain, Etienne Brain, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 (CRIStAL), Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CRLCC Eugène Marquis (CRLCC), Unité de biostatistiques, CRLCC Val d'Aurelle - Paul Lamarque, Department of Medical Oncology [Saint-Cloud], Institut Curie [Saint-Cloud], Département de radiothérapie [Bordeaux], Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Institut Claudius Regaud, CHU Limoges, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Département d'oncologie médicale [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), Service de radiothérapie, Département de Recherche Translationnelle, Institut Curie [Paris], Centre Paul Strauss, CRLCC Paul Strauss, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), CRLCC Jean Godinot, Service d'Oncologie Médicale, CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Medical Oncology Department, Salah Azaiz Institute, Oncogénèse et progression tumorale, Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Lille Nord de France (COMUE)-UNICANCER, Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), and Département de recherche translationnelle
Subjects: 0301 basic medicine, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Neurological progression-free survival, [SDV]Life Sciences [q-bio], Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Stereotactic radiation therapy, Central Nervous System Neoplasms, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, Epidemiology, medicine, Humans, skin and connective tissue diseases, Retrospective Studies, Proportional hazards model, business.industry, Retrospective cohort study, Brain metastases, Middle Aged, medicine.disease, Metastatic breast cancer, Progression-Free Survival, 3. Good health, Radiation therapy, Treatment Outcome, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, business
Abstract: The aims of the present study were to describe treatment patterns and survival outcomes in patients with central nervous system metastases (CNSM) selected among metastatic breast cancer (MBC) patients included in a retrospective study from the Epidemiological Strategy and Medical Economics (ESME) MBC cohort.Neurological progression-free survival (NPFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Signiﬁcant contributors to NPFS were determined using a multivariate Cox proportional hazards model.After a median follow-up of 42.8 months, of 16 701 patients included in the ESME MBC database, CNSM were diagnosed in 24.6% of patients. The most frequent treatments after diagnosis of CNSM were whole-brain radiotherapy (WBRT) (45.2%) and systemic treatment (59.3%). Median OS and NPFS were 7.9 months (95% CI: 7.2-8.4) and 5.5 months (95% CI: 5.2-5.8), respectively. In multivariate analysis, age70 years (vs50 years; HR = 1.40; 95% CI: 1.24-1.57), triple-negative tumours (vs HER2-/HR+; HR = 1.87; 95% CI: 1.71-2.06), HER2+/HR-tumours (vs HER2-/HR+; HR = 1.14; 95% CI: 1.02-1.27), ≥3 metastatic sites (vs 3; HR = 1.32; 95% CI: 1.21-1.43) and ≥3 previous treatment lines (vs 3; HR = 1.75; 95% CI: 1.56-1.96) were detrimental for NPFS. A time interval between selection and CNSM diagnosis superior to 18 months (vs9 months; HR = 0.88; 95% CI: 0.78-0.98) was associated with longer NPFS.This study describes current treatment patterns of MBC patients in a "real life" setting. Despite advances in stereotactic radiation therapy, most of the patients still received WBRT. More research is warranted to identify patient subsets for tailored treatment strategies.
Published: 2020

26. Uptake of Pineal Gland Visible on 18F-DOPA PET/CT With Last Generation of SiPM PET/CT

Author: Pierre Vera, Olivier Humbert, Sébastien Hapdey, Aude Marie-Cardine, Pierre Decazes, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU), Laboratoire d'Electronique, d'Informatique et d'Image [EA 7508] (Le2i), Université de Technologie de Belfort-Montbeliard (UTBM)-Université de Bourgogne (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen], Physiopathologie, Autoimmunité, maladies Neuromusculaires et THErapies Régénératrices (PANTHER), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), and ANR-19-P3IA-0002,3IA@cote d'azur,3IA Côte d'Azur(2019)
Subjects: Movement disorders, Adolescent, [SDV]Life Sciences [q-bio], Partial volume, Astrocytoma, Pineal Gland, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Pineal gland, 0302 clinical medicine, Silicon photomultiplier, Positron Emission Tomography Computed Tomography, Medicine, Humans, Radiology, Nuclear Medicine and imaging, ComputingMilieux_MISCELLANEOUS, PET-CT, Pilocytic astrocytoma, business.industry, Biological Transport, General Medicine, medicine.disease, Dihydroxyphenylalanine, 18f dopa, medicine.anatomical_structure, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, medicine.symptom, business, Nuclear medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, DOPA decarboxylase activity
Abstract: A 17-year-old girl underwent an F-DOPA brain PET/CT on a new high-resolution digital SiPM PET/CT (Vision600 Siemens) to explore a suspicion of recurrence of a pilocytic astrocytoma. This study showed a local recurrence, but a second intense focal uptake was visible above, more intense than striata. On fused MRI, this was the pineal gland considered as physiological. This physiological uptake, due to a pineal DOPA decarboxylase activity, has also been observed with this PET system in other patients with F-DOPA to explore movement disorders. New high-resolution PET can show uptake of small structures by being less dependent to partial volume effect.
Published: 2020

27. Lower Subcutaneous or Visceral Adiposity Assessed by Abdominal Computed Tomography Could Predict Adverse Outcome in Patients With Crohn’s Disease

Author: Romain Modzelewski, Jean-Nicolas Dacher, Claire Thiberge, C. Savoye-Collet, Guillaume Savoye, André Gillibert, Cloé Charpentier, Service de Radiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Unité de biostatistiques [CHU Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and UNIROUEN - UFR Santé (UNIROUEN UFR Santé)
Subjects: Adult, Male, Radiography, Abdominal, Sarcopenia, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Radiography, Intra-Abdominal Fat, Severity of Illness Index, Gastroenterology, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Predictive Value of Tests, Internal medicine, Outcome Assessment, Health Care, Severity of illness, medicine, Humans, Correlation of Data, Muscle, Skeletal, Retrospective Studies, body composition, Crohn's disease, business.industry, computed tomography, Retrospective cohort study, General Medicine, medicine.disease, Subcutaneous Fat, Abdominal, 3. Good health, 030220 oncology & carcinogenesis, Predictive value of tests, Female, 030211 gastroenterology & hepatology, France, Underweight, medicine.symptom, Tomography, X-Ray Computed, business, Body mass index
Abstract: Background and Aims Changes in body composition have been described in patients with Crohn's disease, but their predictive performances on disease evolution remain undefined. The aims of our study were to assess, in patients with Crohn's disease requiring abdominal computed tomography, body composition by computed tomography, and to study the outcome according to various body composition parameters at the time of the computed tomography. Methods Patients with Crohn's disease who underwent abdominal computed tomography for suspected complications were retrospectively included. The definition of adverse outcome included death or need for surgery within 6 months of the computed tomography. Skeletal muscle index and visceral and subcutaneous adiposity indexes were calculated from tissue surface areas measured at the third lumbar vertebra, divided by the height squared. Results The prevalence of underweight was 26.8% and the prevalence of sarcopenia was 33.6%. After gender adjustment, skeletal muscle index tended to be reduced in patients with adverse outcome, compared with patients without surgery or death [p = 0.07]. Moreover, subcutaneous adiposity index and visceral adiposity index were significantly lower in patients with surgery or death [p = 0.009 and p < 0.001, respectively]. These differences were almost equivalent in both genders for the subcutaneous adiposity index but were clearly stronger in men for the visceral adiposity index. Conclusions Subcutaneous and visceral adiposity indexes correlate inversely with adverse outcome in patients with Crohn's disease. Alteration of body composition assessed by computed tomography in these patients appears to be a marker of disease severity.
Published: 2018

28. Lenalidomide in combination with R-CHOP (R2-CHOP) as first-line treatment of patients with high tumour burden follicular lymphoma: a single-arm, open-label, phase 2 study

Author: Steven Le Gouill, Hervé Tilly, Reda Bouabdallah, Stéphanie Becker, Thierry Lamy, Jean Gabarre, Gilles Salles, Corinne Haioun, Fabrice Jardin, José Cabeçadas, Franck Morschhauser, Pierre Feugier, Nicolas Mounier, Olivier Casasnovas, Thierry Jo Molina, Olivier Tournilhac, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biophysique, Médecine Nucléaire et Technologies Médicales (EA 1049), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Hôtel Dieu, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Role of intra-Clonal Heterogeneity and Leukemic environment in ThErapy Resistance of chronic leukemias (CHELTER), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Service d'Hématologie clinique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Instituto Português de Oncologia de Lisboa Francisco Gentil, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Gvh et Gvl : Physiopathologie Chez l'Homme et Chez l'Animal, Incidence et Role Therapeutique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université de Rennes (UR)-Hôpital Pontchaillou
Subjects: Male, medicine.medical_specialty, Vincristine, Cyclophosphamide, [SDV]Life Sciences [q-bio], Follicular lymphoma, Phases of clinical research, Kaplan-Meier Estimate, CHOP, Antibodies, Monoclonal, Murine-Derived, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, hemic and lymphatic diseases, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Lenalidomide, Lymphoma, Follicular, ComputingMilieux_MISCELLANEOUS, Aged, business.industry, Hematology, Middle Aged, medicine.disease, Thalidomide, Tumor Burden, 3. Good health, Doxorubicin, 030220 oncology & carcinogenesis, Prednisone, Female, Rituximab, business, 030215 immunology, medicine.drug
Abstract: Summary Background Immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is a standard front-line treatment for follicular lymphoma. The combination of lenalidomide and rituximab has shown high efficacy in relapsed or refractory and untreated follicular lymphoma. We aimed to evaluate the safety and activity of the combination of lenalidomide and R-CHOP (R2-CHOP) in previously untreated patients with high burden follicular lymphoma. Methods This single-arm, open-label, multicentre, phase 2 trial was done in 16 hospitals in France, all of which were Lymphoma Study Association (LYSA) sites. Eligible patients were aged 18–70 years and had previously untreated CD20-positive follicular lymphoma of grade 1, 2, or 3a; at least one high tumour burden criterion according to Groupe d'Etude des Lymphomes Folliculaires criteria; an Eastern Cooperative Oncology Group performance status score of 2 or less; and a minimum life expectancy of more than 3 months. Patients received induction therapy with six cycles of R2-CHOP every 3 weeks (one cycle involved standard R-CHOP on days 1–5, and 25 mg oral lenalidomide per day on days 1–14), followed by two rituximab infusions at 3-week intervals. The total treatment schedule was 24 weeks. Patients who achieved a complete or partial response to induction therapy received maintenance therapy consisting of one rituximab infusion every 8 weeks for 2 years. The primary outcome was the proportion of patients who achieved a complete response (complete response and complete response unconfirmed), according to International Workshop to Standardize Response Criteria, at the end of induction treatment. Safety was assessed in all patients who completed treatment. This trial is registered with ClinicalTrials.gov , number NCT01393756 , and is closed to accrual. Findings Between Dec 21, 2010, and Jan 25, 2012, 80 patients were enrolled, and 68 (85%) completed six cycles of R2-CHOP. At the end of the induction phase, 59 patients achieved a complete response (74%, 95% CI 63–83). 55 patients achieved a complete response at 30 months from enrolment (69%, 57–78). The most frequent adverse event was grade 4 neutropenia in 52 (65%) patients. The most frequent non-haematological side-effects included grade 1–2 sensory neuropathy in 28 (35%) patients and grade 1–2 transient rash in 27 (34%) patients. Four patients died during the study period; none of these deaths were judged to be related to treatment. Interpretations Lenalidomide in combination with R-CHOP had an acceptable safety profile and showed anti-cancer activity in patients with previously untreated high burden follicular lymphoma. A future comparative study showing evidence of a survival advantage would be necessary for this combination to be proposed as a treatment for follicular lymphoma. Funding French Ministry of Health, Celgene Corporation, and Amgen France.
Published: 2018

29. Feasibility of biventricular volume and function assessment using first-pass gated 15O-water PET

Author: Fayçal Ben Bouallègue, Alain Manrique, Denis Agostini, Denis Mariano-Goulart, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Groupe coeur et ischémie, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), MORNET, Dominique, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: lcsh:Medical physics. Medical radiology. Nuclear medicine, medicine.medical_specialty, First-pass, [SDV]Life Sciences [q-bio], lcsh:R895-920, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, 15o water, 03 medical and health sciences, 15O-water PET, 0302 clinical medicine, Internal medicine, Medicine, Radiology, Nuclear Medicine and imaging, Ventricular function, Cardiac imaging, First pass, Ejection fraction, business.industry, Stroke volume, Perfusion reserve, Regadenoson, [SDV] Life Sciences [q-bio], Ventricular volume, Cardiology, business, Volume (compression), medicine.drug
Abstract: International audience; BackgroundWe investigated the feasibility of left ventricular (LV) and right ventricular (RV) volume and function estimation using a first-pass gated 15O-water PET. This prospective study included 19 patients addressed for myocardial perfusion reserve assessment using 15O-water PET. PET data were acquired at rest and after regadenoson stress, and gated first-pass images were reconstructed over the time range corresponding to tracer first-pass through the cardiac cavities and post-processed using TomPool software; LV and RV were segmented using a semi-automated 4D immersion algorithm. LV volumes were computed using a count-based model and a fixed threshold at 30% of the maximal activity. RV volumes were computed using a geometrical model and an adjustable threshold that was set so as to fit LV and RV stroke volumes. Ejection curves were fitted using a deformable reference curve model. LV results were compared to those obtained using 99mTc-sestamibi gated myocardial SPECT in terms of end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF).ResultsThere was an excellent concordance between rest and stress PET in terms of EDV and ESV (Lin’s coefficient ~ 0.85–0.90), SV (~ 0.80), and EF (~ 0.75) for both ventricles. Correlation with myocardial SPECT was high for LV EDV (Pearson’s R = 0.89, p
Published: 2018

30. Non-invasive monitoring of diffuse large B-cell lymphoma by cell-free DNA high-throughput targeted sequencing: analysis of a prospective cohort

Author: Hélène Lanic, Pierre-Julien Viailly, Philippe Bertrand, Philippe Ruminy, Stéphanie Becker, Louis-Ferdinand Pepin, Vincent Camus, Emilie Lemasle, Julie Libraire, Elodie Bohers, Stéphane Leprêtre, Vinciane Marchand, Sandrine Vaudaux, Catherine Maingonnat, Pascaline Etancelin, Pascal Lenain, Jean-Michel Picquenot, Anne-Lise Menard, Fabrice Jardin, Pierre Vera, Aspasia Stamatoullas, Nathalie Contentin, Hervé Tilly, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-CRLCC Henri Becquerel, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service d'Hématologie, CRLCC Henri Becquerel, Service d'hématologie, Unité de recherche clinique, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU), CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Unité de recherche clinique [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), This research was supported by grants from the Cancéropole Nord-Ouest, the Ligue Contre le Cancer, and Henri Becquerel Center., and Breton, Céline
Subjects: Male, 0301 basic medicine, Oncology, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, Antineoplastic Combined Chemotherapy Protocols, Prospective Studies, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, medicine.diagnostic_test, High-Throughput Nucleotide Sequencing, DNA, Neoplasm, Hematology, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Cell-free fetal DNA, 030220 oncology & carcinogenesis, Female, Lymphoma, Large B-Cell, Diffuse, Cell-Free Nucleic Acids, Adult, medicine.medical_specialty, DNA Copy Number Variations, Genotype, [SDV.CAN]Life Sciences [q-bio]/Cancer, Context (language use), lcsh:RC254-282, Article, Young Adult, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Biopsy, Biomarkers, Tumor, medicine, Humans, Clinical significance, Liquid biopsy, Alleles, Aged, business.industry, Liquid Biopsy, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease, Lymphoma, 030104 developmental biology, business, Diffuse large B-cell lymphoma
Abstract: From a liquid biopsy, cell-free DNA (cfDNA) can provide information regarding basal tumoral genetic patterns and changes upon treatment. In a prospective cohort of 30 diffuse large B-cell lymphomas (DLBCL), we determined the clinical relevance of cfDNA using targeted next-generation sequencing and its correlation with PET scan imaging at the time of diagnosis and during treatment. Using a dedicated DLBCL panel, mutations were identified at baseline for 19 cfDNAs and profiles were consistent with expected DLBCL patterns. Tumor burden-related clinical and PET scan features (LDH, IPI, and metabolic tumor volume) were significantly correlated with the quantity of tumoral cfDNA. Among the four patients presenting additional mutations in their cfDNAs, three had high metabolic tumor volumes, suggesting that cfDNA more accurately reflects tumor heterogeneity than tissues biopsy itself. Mid-treatment, four patients still had basal mutations in their cfDNAs, including three in partial response according to their Deauville scores. Our study highlights the major interests in liquid biopsy, in particular in the context of bulky tumors where cfDNA allows capturing the entire tumoral mutation profile. Therefore, cfDNA analysis in DLBCL represents a complementary approach to PET scan imaging.
Published: 2018

31. Gaussian-based Spatial Hybrid Distances for Detection and Segmentation of Lymphoid Lesions in 3D PET Images

Author: Pierre Vera, Haigen Hu, Pierre Decazes, Jerome Lapuyade-Lahorgue, Su Ruan, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: DBSCAN, Similarity (geometry), business.industry, Computer science, Gaussian, Pattern recognition, 3. Good health, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Feature (computer vision), [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], symbols, Gaussian function, Segmentation, Artificial intelligence, Cluster analysis, business, ComputingMilieux_MISCELLANEOUS, 030217 neurology & neurosurgery
Abstract: Detection and segmentation of lymphoid lesions from PET/CT images is a crucial task for cancer staging and treatment monitoring. However, it is still a challenging task owing to the fact that there are not fixed locations, obvious feature information, shapes and sizes for lymphomas in PET images. In this work, a spatial hybrid distance (SHD) methodology is proposed for detection and segmentation of 3D PET images. Based on Gaussian kernel function, the SHDs are defined by combining different feature attributes including some priori knowledge about organ distribution, and spatial positions. A clustering method using SHD is proposed to detect and segment the lymphoma. Finally, a series of comparison experiments are performed based on DBSCAN algorithm, and the results show that the propoded SHD can achieve better performance than traditional similarity measures, and it can provide an unsupervised detection and segmentation of Iymphoid lesions in 3D PET images.
Published: 2019

32. Influence of adjuvant chemotherapy on anti-Müllerian hormone in women below 35 years treated for early breast cancer

Author: Marion David, Marie Degremont, Agnès Loeb, Zena Khaznadar, Marianne Leheurteur, Anne Perdrix, Frédéric Di Fiore, Mathilde Saint-Ghislain, Florian Clatot, Génétique du cancer et des maladies neuropsychiatriques (GMFC), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Centre de sociologie des organisations (Sciences Po, CNRS) (CSO), Sciences Po (Sciences Po)-Centre National de la Recherche Scientifique (CNRS), Neurobiologie des interactions cellulaires et neurophysiopathologie - NICN (NICN), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS), Service d'Oncologie Médicale, CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Centre de sociologie des organisations (CSO), and Centre National de la Recherche Scientifique (CNRS)-Université de la Méditerranée - Aix-Marseille 2
Subjects: Anti-Mullerian Hormone, Counseling, Oncology, medicine.medical_treatment, 0302 clinical medicine, Limit of Detection, Medicine, Anthracyclines, Ovarian tissue cryopreservation, Age of Onset, Child, Ovarian Reserve, ComputingMilieux_MISCELLANEOUS, Early Detection of Cancer, media_common, Immunoassay, 030219 obstetrics & reproductive medicine, biology, Obstetrics and Gynecology, Anti-Müllerian hormone, 3. Good health, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Female, Taxoids, Adult, endocrine system, medicine.medical_specialty, Adolescent, media_common.quotation_subject, [SDV.CAN]Life Sciences [q-bio]/Cancer, Breast Neoplasms, Fertility, Young Adult, 03 medical and health sciences, Breast cancer, Internal medicine, Humans, Antineoplastic Agents, Alkylating, Retrospective Studies, Cryopreservation, Gynecology, Chemotherapy, urogenital system, business.industry, Ovary, Cancer, medicine.disease, Survival Analysis, Regimen, Reproductive Medicine, biology.protein, business, Biomarkers, Developmental Biology, Hormone
Abstract: The impact of chemotherapy on fertility appears to be of essential importance for the youngest cancer survivors. The aim of this study was to assess plasma anti-Mullerian hormone (AMH) evolution, using an automated sensitive AMH immunoassay in women younger than 35 years old before and after treatment with adjuvant chemotherapy for early breast cancer. We selected 54 women aged less than 35 years old, at the time of breast cancer diagnosis, who received chemotherapy between 2008 and 2014, and with plasma samples collected from the diagnosis, to 1 year, 3 years and 5 years post-diagnosis. The median AMH decreased markedly in the year after the diagnosis compared with the pretreatment values (P < 0.0001), and slightly increased 2 years later (P = 0.007, comparing 1-year and 3-years post-diagnosis concentrations), without any additional AMH recovery 5 years after diagnosis. This recovery did not reach age-dependent AMH expected values (P < 0.0001, comparing AMH measured values to AMH expected values). Addition of taxanes to an anthracyclines + alkylating-based regimen was associated with a worse AMH decrease (P = 0.007). Ovarian tissue cryopreservation before treatment did not influence the AMH recovery. These results highlight the necessity of fertility counselling before treatment, especially in women wanting children.
Published: 2017

33. Anthropometer3D: Automatic Multi-Slice Segmentation Software for the Measurement of Anthropometric Parameters from CT of PET/CT

Author: Pierre Decazes, David Tonnelet, Isabelle Gardin, Pierre Vera, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Adult, Male, Positron emission tomography, [SDV]Life Sciences [q-bio], Population, Multi-atlas segmentation, Intra-Abdominal Fat, computer.software_genre, Body composition, Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Atlases as Topic, Imaging, Three-Dimensional, 0302 clinical medicine, Software, Sørensen–Dice coefficient, Fluorodeoxyglucose F18, Voxel, Positron Emission Tomography Computed Tomography, medicine, Humans, Whole Body Imaging, Radiology, Nuclear Medicine and imaging, Segmentation, Muscle, Skeletal, education, Computed tomography, Aged, Mathematics, education.field_of_study, PET-CT, Anthropometry, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Middle Aged, Computer Science Applications, Adipose Tissue, Lean body mass, Female, Radiopharmaceuticals, Nuclear medicine, business, computer, 030217 neurology & neurosurgery
Abstract: International audience; Anthropometric parameters like muscle body mass (MBM), fat body mass (FBM), lean body mass (LBM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) are used in oncology. Our aim was to develop and evaluate the software Anthropometer3D measuring these anthropometric parameters on the CT of PET/CT. This software performs a multi-atlas segmentation of CT of PET/CT with extrapolation coefficients for the body parts beyond the usual acquisition range (from the ischia to the eyes). The multi-atlas database is composed of 30 truncated CTs manually segmented to isolate three types of voxels (muscle, fat, and visceral fat). To evaluate Anthropomer3D, a leave-one-out cross-validation was performed to measure MBM, FBM, LBM, VAT, and SAT. The reference standard was based on the manual segmentation of the corresponding whole-body CT. A manual segmentation of one CT slice at level L3 was also used. Correlations were analyzed using Dice coefficient, intra-class coefficient correlation (ICC), and Bland-Altman plot. The population was heterogeneous (sex ratio 1:1; mean age 57 years old [min 23; max 74]; mean BMI 27 kg/m2 [min 18; max 40]). Dice coefficients between reference standard and Anthropometer3D were excellent (mean+/-SD): muscle 0.95 ± 0.02, fat 1.00 ± 0.01, and visceral fat 0.97 ± 0.02. The ICC was almost perfect (minimal value of 95% CI of 0.97). All Bland-Altman plot values (mean difference, 95% CI and slopes) were better for Anthropometer3D compared to L3 level segmentation. Anthropometer3D allows multiple anthropometric measurements based on an automatic multi-slice segmentation. It is more precise than estimates using L3 level segmentation.
Published: 2019

34. Radiotherapy boost in patients with hypoxic lesions identified by 18F-FMISO PET/CT in non-small-cell lung carcinoma: can we expect a better survival outcome without toxicity? [RTEP5 long-term follow-up]

Author: Louis-Ferdinand Pepin, Sébastien Hapdey, Bernard Dubray, Pierre Vera, J. Lequesne, Sorina-Dana Mihailescu, Pierre Decazes, Philippe Chaumet-Riffaud, Romain Modzelewski, Pierre Bohn, Sébastien Thureau, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Département de radiothérapie et de physique médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service de Biophysique et de Médecine Nucléaire, and AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
Subjects: Oncology, medicine.medical_specialty, Positron emission tomography, medicine.medical_treatment, [SDV]Life Sciences [q-bio], [SDV.CAN]Life Sciences [q-bio]/Cancer, Radiotherapy dose, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Carcinoma, Radiology, Nuclear Medicine and imaging, Lung cancer, Hypoxia, Lung, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, 3. Good health, respiratory tract diseases, Clinical trial, Radiation therapy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Toxicity, 18F-Fluoromisonidazole, business, Chemoradiotherapy, Fluorodeoxy-D-glucose
Abstract: Chemoradiotherapy is the reference curative-intent treatment for nonresectable locally advanced non-small-cell lung carcinoma (NSCLC), with unsatisfactory survival, partially due to radiation resistance in hypoxic tissues. The objective was to update survival and toxicity at 3 years following radiotherapy boost to hypoxic tumours in NSCLC patients treated with curative-intent chemoradiotherapy. This was an open-label, nonrandomized, multicentre, phase II clinical trial. 18F-Fluoromisonidazole (18F-FMISO) PET/CT was used to determine the hypoxic profile of the patients. 18F-FMISO-positive patients and those without organ-at-risk constraints received a radiotherapy boost (70–84 Gy); the others received standard radiotherapy (66 Gy). Overall survival (OS), progression-free survival (PFS) and safety were assessed. A total of 54 patients were evaluated. OS and PFS rates at 3 years were 48.5% and 28.8%, respectively. The median OS in the 18F-FMISO-positive patients was 25.8 months and was not reached in the 18F-FMISO-negative patients (p = 0.01). A difference between the groups was also observed for PFS (12 months vs. 26.2 months, p = 0.048). In 18F-FMISO-positive patients, no difference was observed in OS in relation to dose, probably because of the small sample size (p = 0.30). However, the median OS seemed to be in favour of patients who received the radiotherapy boost (26.5 vs. 15.3 months, p = 0.71). In patients who received the radiotherapy boost, no significant late toxicities were observed. 18F-FMISO uptake in NSCLC patients is strongly associated with features indicating a poor prognosis. In 18F-FMISO-positive patients, the radiotherapy boost seemed to improve the OS by 11.2 months. A further clinical trial is needed to investigate the efficacy of a radiotherapy boost in patients with hypoxic tumours.
Published: 2019

35. 3-D RPET-NET: Development of a 3-D PET Imaging Convolutional Neural Network for Radiomics Analysis and Outcome Prediction

Author: Su Ruan, Amine Amyar, Clément Chatelain, Romain Modzelewski, Isabelle Gardin, Pierre Decazes, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), and Equipe Apprentissage (DocApp - LITIS)
Subjects: Computer science, [SDV]Life Sciences [q-bio], Feature extraction, Standardized uptake value, 02 engineering and technology, Convolutional neural network, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Margin (machine learning), 0202 electrical engineering, electronic engineering, information engineering, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Radiology, Nuclear Medicine and imaging, Segmentation, Instrumentation, ComputingMilieux_MISCELLANEOUS, medicine.diagnostic_test, business.industry, Pattern recognition, Atomic and Molecular Physics, and Optics, 3. Good health, Random forest, Positron emission tomography, 020201 artificial intelligence & image processing, Artificial intelligence, business, Volume (compression)
Abstract: Radiomics is now widely used to improve the prediction of treatment response and patient prognosis in oncology. In this paper, we propose an end-to-end prediction model based on a 3-D convolutional neural network (CNN), called 3-D RPET-NET, that extracts 3-D image features through four layers. Our model was evaluated for its ability to predict the response to radio-chemotherapy in 97 patients with esophageal cancer from positron emission tomography (PET) images. The accuracy of the model was compared to five other methods proposed in the literature for PET images, based on 2-D CNN and random forest algorithms. The role of the volume of interest on the accuracy of 3-D RPET-NET was also evaluated using isotropic margins of 1–4 cm around the tumor volume. After segmentation of the lesion using a fixed threshold value of 40% of the maximum standard uptake value, the best accuracy of 3-D RPET-NET reached 72% and outperformed the other methods tested. We also showed that using an isotropic margin of 2 cm around the tumor volume improved the performances of 3-D RPET-NET to reach an accuracy of 75%.
Published: 2019

36. Comparison of therapeutic evaluation criteria in FDG-PET/CT in patients with diffuse large-cell B-cell lymphoma: Prognostic impact of tumor/liver ratio

Author: Hervé Tilly, Pierre Vera, Fabrice Jardin, Stéphanie Becker, Mathieu Nessim Toledano, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Groupe d'étude des proliférations lymphoïdes (GPL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Service d'Hématologie, and Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Male, Multivariate analysis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Cancer Treatment, Diagnostic Radiology, Hematologic Cancers and Related Disorders, Mathematical and Statistical Techniques, 0302 clinical medicine, immune system diseases, Positron Emission Tomography Computed Tomography, hemic and lymphatic diseases, Medicine and Health Sciences, Medicine, B-cell lymphoma, Tomography, health care economics and organizations, Aged, 80 and over, Univariate analysis, Multidisciplinary, medicine.diagnostic_test, Pharmaceutics, Radiology and Imaging, Statistics, Liver Neoplasms, Hematology, Middle Aged, Prognosis, Oncology, Liver, Positron emission tomography, 030220 oncology & carcinogenesis, Physical Sciences, Regression Analysis, Lymphomas, Female, Lymphoma, Large B-Cell, Diffuse, Research Article, Clinical Oncology, Adult, Adolescent, Imaging Techniques, Science, Neuroimaging, Research and Analysis Methods, Disease-Free Survival, Cancer Chemotherapy, Young Adult, 03 medical and health sciences, Drug Therapy, Diagnostic Medicine, Chemotherapy, Humans, Statistical Methods, neoplasms, Aged, Retrospective Studies, Receiver operating characteristic, business.industry, Large cell, Biology and Life Sciences, Cancers and Neoplasms, medicine.disease, ROC Curve, Multivariate Analysis, Clinical Medicine, business, Nuclear medicine, Diffuse large B-cell lymphoma, Mathematics, Positron Emission Tomography, Neuroscience, 030215 immunology
Abstract: PurposeThe study objective was to compare the prognostic value of interim and end-of-treatment FDG PET/CT using five therapeutic evaluation criteria in patients with diffuse large B cell lymphoma (DLBCL).Methods181 patients were retrospectively analysed. All patients underwent FDG-PET at baseline and after four cycles (iPET4) of first-line chemotherapy and 165 at the end-of-treatment (PET-eot). Ratio Deauville score (rDS) (SUVmax-target residual lesion/SUVmax-liver) was measured in iPET4 and PET-eot, and its optimal threshold was determined using receiver operating characteristic (ROC) curve analysis. Deauville score (DS) (iPET4 and PET-eot), ΔSUVmax, ΔSUVmax determined according to Menton 2011 criteria (ΔSUVmax+DS) and ΔSUVmax+rDS were also evaluated (iPET4 only). Median follow-up was 44 months.ResultsROC analysis revealed the optimal cut-off value was 1.4-fold of SUVmax-liver on iPET4 and PET-eot. On iPET4, positive predictive value (PPV) of rDS was significantly better than DS: 81.58% vs. 67.79%. In univariate analysis, the five interpretation methods were statistically significant (pConclusionsrDS with a tumor/liver ratio of 1.4 is a robust prognostic factor in patients with DLBCL on iPET4 and PET-eot.
Published: 2019

37. Radiomics : principles and radiotherapy applications

Author: Hortense A. Kirisli, Juliette Thariat, David Gibon, Pierre Vera, V. Grégoire, Isabelle Gardin, David Pasquier, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Aquilab, Service de radiothérapie / curiethérapie, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER-Université Lille Nord de France (COMUE)-UNICANCER, Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 (CRIStAL), Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Université de Lille-UNICANCER, Université Lille Nord de France (COMUE)-UNICANCER, and Université de Lille-UNICANCER-Université de Lille-UNICANCER
Subjects: Diagnostic Imaging, 0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Medical Oncology, 03 medical and health sciences, 0302 clinical medicine, Radiomics, Neoplasms, Image Interpretation, Computer-Assisted, medicine, Humans, Medical physics, Modality (human–computer interaction), Radiotherapy, business.industry, Patient survival, Hematology, Method of analysis, Chemoradiotherapy, Response to treatment, 3. Good health, Radiation therapy, Identification (information), 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Medical imaging, business
Abstract: International audience; Radiomics is defined as the extraction of a large quantity of quantitative image features. The different radiomic indexes that have been proposed in the literature are described as well as the various factors that have an impact on the robustness of these indexes. We will see that several hundred quantitative features can be extracted per lesion and imaging modality. The ever-growing number of features studied raises the question of the statistical method of analysis used.This review addresses the research supporting the clinical use of radiomics in oncology in the staging of disease, discrimination between healthy and pathological tissues, the identification of genetic features, the prediction of patient survival, the response to treatment, the recurrence after radiotherapy and chemoradiotherapy and the side effects.Based on the existing literature, it remains difficult to identify features that should be used for current clinical practice.
Published: 2019

38. Delineation of lung cancer with FDG PET/CT during radiation therapy

Author: Pierre Vera, Romain Modzelewski, Sébastien Hapdey, J. Ganem, Isabelle Gardin, Sébastien Thureau, Département de radiothérapie et de physique médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Adult, Male, lcsh:Medical physics. Medical radiology. Nuclear medicine, Lung Neoplasms, PET/CT, medicine.medical_treatment, lcsh:R895-920, [SDV]Life Sciences [q-bio], Standardized uptake value, [SDV.CAN]Life Sciences [q-bio]/Cancer, lcsh:RC254-282, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Carcinoma, Non-Small-Cell Lung, Positron Emission Tomography Computed Tomography, Image Interpretation, Computer-Assisted, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective cohort study, Lung cancer, Aged, Aged, 80 and over, Clinical Trials as Topic, PET-CT, Lung, medicine.diagnostic_test, business.industry, Radiotherapy Planning, Computer-Assisted, Research, Gold standard (test), Delineation, Middle Aged, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Radiation therapy, medicine.anatomical_structure, Oncology, Positron emission tomography, 030220 oncology & carcinogenesis, Female, Nuclear medicine, business, perPET-RT
Abstract: To propose an easily applicable segmentation method (perPET-RT) for delineation of tumour volume during radiotherapy on interim fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with non-small cell lung cancer (NSCLC). Sixty-seven patients (51 primary tumours, 60 lymph nodes), from 4 prospective studies, underwent an FDG PET/CT scan during the fifth week of radiation therapy, using different generations of PET/CT. Per-therapeutic PET/CT scans were delineated in consensus by two experienced physicians leading to the gold standard threshold to be applied. The mathematical expression of Thopt, the optimal threshold to be applied as a function of the maximum standard uptake value (SUVmax), was determined. The performance of this method (perPET-RT) was assessed by computing the DICE similarity coefficient (DSC) and was compared with 8 fixed threshold values and 3 adaptive thresholding methods. Thopt verified the following expression: Thopt = A.ln(1/SUVmax) + B where A and B were 2 constants. A and B were independent from the generation of PET/CT, but depended on the type of lesions (primary lung tumours vs. lymph nodes). PerPET-RT showed good to very good agreement in comparison to the gold standard. The mean and standard deviation of DSC value was 0.81 ± 0.13 for lung lesions and 0.78 ± 0.15 for lymph nodes. PerPET-RT showed a significant better agreement than the other segmentation methods (p
Published: 2018

39. A new methodology to derive 3D kinetic parametric FDG PET images based on a mathematical approach integrating an error model of measurement

Author: Laetitia Padovani, Bardia Farman Ara, Arthur Dumouchel, J. Lequesne, Sébastien Thureau, David Taïeb, Isabelle Gardin, S Delcourt, Dominique Barbolosi, Elyse Colard, Sébastien Hapdey, Pierre Vera, P. Gouel, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Département de radiothérapie et de physique médicale, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: lcsh:Medical physics. Medical radiology. Nuclear medicine, Wilcoxon signed-rank test, lcsh:R895-920, [SDV]Life Sciences [q-bio], Dynamic PET, computer.software_genre, Patlak plot, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Voxel, Quantification, Medicine, Radiology, Nuclear Medicine and imaging, Cardiac imaging, Parametric imaging, Original Research, Parametric statistics, Clinical Oncology, FDG kinetics, business.industry, Fdg uptake, Limits of agreement, 3. Good health, carbohydrates (lipids), 030220 oncology & carcinogenesis, Lung cancer, business, Nuclear medicine, computer
Abstract: Background In FDG-PET, SUV images are hampered by large potential biases. Our aim was to develop an alternative method (ParaPET) to generate 3D kinetic parametric FDG-PET images easy to perform in clinical oncology. Methods The key points of our method are the use of a new error model of PET measurement extracted from a late dynamic PET acquisition of 15 min, centered over the lesion and an image-derived input function (IDIF). The 15-min acquisition is reconstructed to obtain five images of FDG mean activity concentration and images of its variance to model errors of PET measurement. Our approach is carried out on each voxel to derive 3D kinetic parameter images. ParaPET was evaluated and compared to Patlak analysis as a reference. Hunter and Barbolosi methods (Barbolosi-Bl: with blood samples or Barbolosi-Im: with IDIF) were also investigated and compared to Patlak. Our evaluation was carried on K i index, the net influx rate and its maximum value in the lesion (K i,max). Results This parameter was obtained from 41 non-small cell lung cancer lesions associated with 4 to 5 blood samples per patient, required for the Patlak analysis. Compare to Patlak, the median relative difference and associated range (median; [min;max]) in K i,max estimates were not statistically significant (Wilcoxon test) for ParaPET (− 3.0%; [− 31.9%; 47.3%]; p = 0.08) but statistically significant for Barbolosi-Bl (− 8.0%; [− 30.8%; 53.7%]; p = 0.001), Barbolosi-Im (− 7.9%; [− 38.4%; 30.6%]; p = 0.007) or Hunter (32.8%; [− 14.6%; 132.2%]; p
Published: 2018

40. FDG and FMISO PET-guided dose escalation with intensity-modulated radiotherapy in lung cancer

Author: Sébastien Hapdey, Romain Modzelewski, Pierre Bohn, Sabine Vincent, Sébastien Thureau, Nicolas Pirault, Gouel Pierrick, Bernard Dubray, Pierre Vera, David Gensanne, Elodie Anger, Département de radiothérapie et de physique médicale, Cancéropole Nord-Ouest-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Male, Organs at Risk, Lung Neoplasms, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 18fluoro-deoxy-D-glucose, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, Dose escalation, Prospective Studies, Hypoxia, Prospective cohort study, medicine.diagnostic_test, Fmiso pet, Radiotherapy Dosage, Middle Aged, Prognosis, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Tumor Burden, 3. Good health, Oncology, Positron emission tomography, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Female, Intensity modulated radiotherapy, Lung cancer, Adult, lcsh:Medical physics. Medical radiology. Nuclear medicine, 18fluoro-misonidasole, lcsh:R895-920, [SDV.CAN]Life Sciences [q-bio]/Cancer, Adenocarcinoma, lcsh:RC254-282, 03 medical and health sciences, Fluorodeoxyglucose F18, medicine, Humans, Radiology, Nuclear Medicine and imaging, Misonidazole, Aged, Radiotherapy, business.industry, Research, medicine.disease, Radiation therapy, Positron-Emission Tomography, Concomitant, Radiotherapy, Intensity-Modulated, Radiopharmaceuticals, Nuclear medicine, business, Follow-Up Studies, Radiotherapy, Image-Guided
Abstract: Background Concomitant chemo-radiotherapy is the reference treatment for non-resectable locally-advanced Non-Small Cell Lung Cancer (NSCLC). Increasing radiotherapy total dose in the whole tumour volume has been shown to be deleterious. Functional imaging with positron emission tomography (PET/CT) offers the potential to identify smaller and biologically meaningful target volumes that could be irradiated with larger doses without compromising Organs At Risk (OAR) tolerance. This study investigated four scenarios, based on 18FDG and 18F-miso PET/CT, to delineate the target volumes and derive radiotherapy plans delivering up to 74Gy. Method Twenty-one NSCLC patients, selected from a prospective phase II trial, had 18FDG- and 18F-miso PET/CT before the start of radiotherapy and 18FDG PET/CT during the radiotherapy (42Gy). The plans were based planned on a standard plan delivering 66 Gy (plan 1) and on three different boost strategies to deliver 74Gy total dose in pre-treatment 18FDG hotspot (70% of SUVmax) (plan 2), pre-treatment 18F-miso target (SUVmax > 1.4) (plan 3) and per-treatment 18FDG residual (40% of SUVmax). (plan 4). Results The mean target volumes were 4.8 cc (± 1.1) for 18FDG hotspot, 38.9 cc (± 14.5) for 18F-miso and 36.0 cc (± 10.1) for per-treatment 18FDG. In standard plan (66 Gy), the mean dose covering 95% of the PTV (D95%) were 66.5 (± 0.33), 66.1 (± 0.32) and 66.1 (± 0.32) Gy for 18FDG hotspot, 18F-miso and per-treatment 18FDG. In scenario 2, the mean D95% was 72.5 (± 0.25) Gy in 18FDG hotspot versus 67.9 (± 0.49) and 67.9 Gy (± 0.52) in 18F-miso and per-treatment 18FDG, respectively. In scenario 3, the mean D95% was 72.2 (± 0.27) Gy to 18F-miso versus 70.4 (± 0.74) and 69.5Gy (± 0.74) for 18FDG hotspot and per-treatment 18FDG, respectively. In scenario 4, the mean D95% was 73.1 (± 0.3) Gy to 18FDG per-treatment versus 71.9 (± 0.61) and 69.8 (± 0.61) Gy for 18FDG hotspot and 18F-miso, respectively. The dose/volume constraints to OARs were matched in all scenarios. Conclusion Escalated doses can be selectively planned in NSCLC target volumes delineated on 18FDG and 18F-miso PET/CT functional images. The most relevant strategy should be investigated in clinical trials. Trial registration (RTEP5, NCT01576796, registered 15 june 2012)
Published: 2018

41. Molecular Profile and FDG-PET/CT Total Metabolic Tumor Volume Improve Risk Classification at Diagnosis for Patients with Diffuse Large B-Cell Lymphoma

Author: Stéphanie Becker, Pierre Vera, Hervé Tilly, Hélène Lanic, Fabrice Jardin, Anne-Ségolène Cottereau, Sylvain Mareschal, Michel Meignan, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Service d'Hématologie, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Groupe d'étude des proliférations lymphoïdes (GPL), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), and Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)
Subjects: Male, Oncology, Cancer Research, Pathology, Kaplan-Meier Estimate, CHOP, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, immune system diseases, hemic and lymphatic diseases, Positron Emission Tomography Computed Tomography, Antineoplastic Combined Chemotherapy Protocols, Aged, 80 and over, education.field_of_study, Middle Aged, Tumor Burden, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Female, Rituximab, Lymphoma, Large B-Cell, Diffuse, medicine.drug, Adult, medicine.medical_specialty, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, Young Adult, 03 medical and health sciences, Fluorodeoxyglucose F18, Internal medicine, Biomarkers, Tumor, medicine, Humans, education, neoplasms, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Gene Expression Profiling, Retrospective cohort study, Metabolic tumor volume, medicine.disease, Lymphoma, Regimen, ROC Curve, business, Diffuse large B-cell lymphoma
Abstract: Purpose: The prognostic impact of total metabolic tumor volume (TMTV) measured on pretreatment 18F-FDG PET/CT and its added value to molecular characteristics was investigated in patients with diffuse large B-cell lymphoma (DLBCL). Experimental Design: For 81 newly diagnosed patients with DLBCL treated with rituximab and CHOP/CHOP-like regimen, TMTV was computed using the 41% SUVmax thresholding method. According to the gene expression profile, determined using DASL (cDNA-mediated Annealing, Selection, Ligation and extension) technology, a subset of 57 patients was classified in germinal center B (GCB) or activated B-cell (ABC) subtypes and MYC or BCL2 overexpressed. Results: Median follow-up was 64 months. Five-year progression-free survival (PFS) and overall survival (OS) were 60% and 63% in the whole population. Median pretherapy TMTV was 320 cm3 (25th–75th percentiles 106–668 cm3). With a 300 cm3 cutoff, patients with high TMTV (n = 43) had a 5-year PFS and OS of 43% and 46% compared with 76% and 78% for patients with a low TMTV (P = 0.0023, P = 0.0047). ABC status, MYC, or BCL2 overexpression and both overexpression (“dual expressor,” DE) were significantly associated with a worse PFS and OS. TMTV combined with molecular data allowed a significant better risk substratification of ABC/GCB patients, on PFS and OS. High TMTV individualized in molecular-low-risk patients a group with a poor outcome (MYC, PFS=51%, OS=55% BCL2, PFS=49%, OS=49% or DE PFS=50%, OS=50%) and a group with a good outcome (MYC, PFS=93%, OS=93% BCL2, PFS=86%, OS=86%, or DE PFS=81%, OS=81%). Conclusions: The combination of molecular and imaging characteristics at diagnosis could lead to a more accurate selection of patients, to increase tailor therapy. Clin Cancer Res; 22(15); 3801–9. ©2016 AACR.
Published: 2016

42. Outcome after ablation in patients with low-risk thyroid cancer (ESTIMABL1): 5-year follow-up results of a randomised, phase 3, equivalence trial

Author: Isabelle Borget, Marie-Elisabeth Toubert, Danielle Benisvy, Sophie Leboulleux, Slimane Zerdoud, Ellen Benhamou, Désirée Deandreis, Martin Schlumberger, Bogdan Catargi, Claire Schvartz, D. Rusu, Yann Godbert, Stéphane Bardet, Claire Bournaud, Pierre Vera, Olivier Morel, Antony Kelly, Camille Buffet, Université Paris-Saclay, Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), CHU Bordeaux [Bordeaux], Service de médecine nucléaire, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Unité de Médecine Nucléaire [ICO, Saint Herblain], Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER-UNICANCER, Institut Bergonié [Bordeaux], UNICANCER, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Jean Godinot [Reims], Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), Université Côte d'Azur (UCA)-UNICANCER, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), Service de biostatistique et d'épidémiologie (SBE), and Direction de la recherche clinique [Gustave Roussy]
Subjects: Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Levothyroxine, Urology, 030209 endocrinology & metabolism, [SDV.CAN]Life Sciences [q-bio]/Cancer, Internal Medicine, Endocrinology, Thyroid carcinoma, Iodine Radioisotopes, 03 medical and health sciences, 0302 clinical medicine, Adenocarcinoma, Follicular, Medicine, Humans, Thyroid Neoplasms, Thyroid cancer, ComputingMilieux_MISCELLANEOUS, Aged, business.industry, Incidence, Thyroid, Cancer, Middle Aged, medicine.disease, Ablation, Prognosis, Carcinoma, Papillary, 3. Good health, Diabetes and Metabolism, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Thyroidectomy, Thyroglobulin, Female, Neoplasm Recurrence, Local, business, medicine.drug, Hormone, Follow-Up Studies
Abstract: Summary Background In ESTIMABL1, a randomised phase 3 trial of radioactive iodine ( 131 I) administration after complete surgical resection in patients with low-risk thyroid cancer, 92% of patients had complete thyroid ablation at 6–10 months, defined as a recombinant human thyroid-stimulating hormone (rhTSH)-stimulated serum thyroglobulin concentration of 1 ng/mL or less and normal findings on neck ultrasonography. Equivalence was shown between low-activity (1·1 GBq) and high-activity (3·7 GBq) radioactive iodine and also between the use of rhTSH injections and thyroid hormone withdrawal. Here, we report outcomes after 5 years of follow-up. Methods This multicentre, randomised, open-label, equivalence trial was done at 24 centres in France. Between March 28, 2007, and Feb 25, 2010, we randomly assigned (1:1:1:1) adults with low-risk differentiated thyroid carcinoma who had undergone total thyroidectomy to one of four strategies, each combining one of two methods of thyrotropin stimulation (rhTSH or thyroid hormone withdrawal) and one of two radioactive iodine activities (1·1 GBq or 3·7 GBq). Randomisation was by computer-generated sequence, with variable block size. Follow-up consisted of a yearly serum thyroglobulin measurement on levothyroxine treatment. Measurement of rhTSH-stimulated thyroglobulin and neck ultrasonography were done at the discretion of the treating physician. No evidence of disease was defined as serum thyroglobulin of 1 ng/mL or less on levothyroxine treatment and normal results on neck ultrasonography, when performed. This study was registered with ClinicalTrials.gov, number NCT00435851. Findings 726 patients (97% of the 752 patients originally randomised) were followed up. At a median follow-up since randomisation of 5·4 years (range 0·5–9·2), 715 (98%) had no evidence of disease. The other 11 had either structural disease (n=4), raised serum thyroglobulin concentration (n=5), or indeterminate findings on neck ultrasonography (n=2). At ablation, six of these patients had received 1·1 GBq radioactive iodine (five after rhTSH and one after withdrawal) and five had received 3·7 GBq (two after rhTSH and three after withdrawal). TSH-stimulated (either after rhTSH injections or thyroid hormone withdrawal according to the treatment group) thyroglobulin concentration measured at the time of ablation was prognostic for structural disease status at ablation, ablation status at 6–10 months, and the final outcome. Interpretation Our findings suggest that disease recurrence was not related to the strategy used for ablation. These data validate the use of 1·1 GBq radioactive iodine after rhTSH for postoperative ablation in patients with low-risk thyroid cancer. Funding French National Cancer Institute (INCa), French Ministry of Health, and Sanofi Genzyme.
Published: 2018

43. Combination of baseline FDG PET/CT total metabolic tumour volume and gene expression profile have a robust predictive value in patients with diffuse large B-cell lymphoma

Author: Mathieu Nessim Toledano, Philippe Ruminy, Isabelle Gardin, Pierre Vera, Hervé Tilly, Paul Desbordes, Stéphanie Becker, A. Banjar, Fabrice Jardin, Centre de résonance magnétique biologique et médicale (CRMBM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), and Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)
Subjects: Male, medicine.medical_specialty, Multivariate analysis, [SDV]Life Sciences [q-bio], Gastroenterology, Disease-Free Survival, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, International Prognostic Index, Fluorodeoxyglucose F18, Internal medicine, Positron Emission Tomography Computed Tomography, Gene expression, Antineoplastic Combined Chemotherapy Protocols, Medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, business.industry, Gene Expression Profiling, General Medicine, Middle Aged, medicine.disease, Prognosis, 3. Good health, Lymphoma, Tumor Burden, Gene expression profiling, 030220 oncology & carcinogenesis, Tumour volume, Female, Lymphoma, Large B-Cell, Diffuse, Neoplasm Recurrence, Local, business, Transcriptome, Diffuse large B-cell lymphoma
Abstract: This study evaluated the predictive significance of total metabolic tumour volume (TMTV) measured on baseline FDG PET/CT and its value in addition to gene expression profiling using a new method of gene analysis (rapid reverse transcriptase multiplex ligation-dependent probe amplification assay, RT-MLPA) in patients with diffuse large B-cell lymphoma treated with R-CHOP or R-CHOP-like chemotherapies. The analysis included 114 patients. TMTV was measured using a 41% SUVmax threshold and tumours were classified into GCB or ABC subtypes according to the RT-MLPA assay. The median follow-up was 40 months. the 5-year progression-free survival (PFS) was 54% and the 5-year overall survival (OS) was 62%. The optimal TMTV cut-off value was 261 cm3. In 59 patients with a high TMTV the 5-year PFS and OS were 37% and 39%, respectively, in comparison with 72% and 83%, respectively, in 55 patients with a low TMTV (p = 0.0002 for PFS, p
Published: 2018

44. Role of FDG PET-CT in the treatment management of Hodgkin lymphoma

Author: Veronique Edeline, S. Becker, T. Vander Borght, Olivier Casasnovas, Alina Berriolo-Riedinger, Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Département de médecine nucléaire (CHU UCL Namur), CHU UCL Namur, Namur Research Institute for Life Sciences (NARILIS), Département de médecine nucléaire (Institut Curie, Saint-Cloud), and Institut Curie [Paris]
Subjects: medicine.medical_specialty, Interim PET, Neoplasm, Residual, PET-CT, Clinical Decision-Making, [SDV.CAN]Life Sciences [q-bio]/Cancer, Antineoplastic Agents, 030218 nuclear medicine & medical imaging, TEP-scanographie, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, medicine, Humans, Radiology, Nuclear Medicine and imaging, Neoplasm Staging, Fluorodeoxyglucose, Lymphome de Hogkin, Lymphatic Irradiation, business.industry, Advanced stage, Complete remission, Hematopoietic Stem Cell Transplantation, Gold standard (test), Prognosis, Hodgkin Disease, 3. Good health, Treatment management, Oncology, Imagerie, 030220 oncology & carcinogenesis, Hodgkin lymphoma, Fdg pet ct, Radiology, Tomography, Lymph Nodes, Radiopharmaceuticals, business, medicine.drug, Radiotherapy, Image-Guided
Abstract: IF 1.128; International audience; Fluorodeoxyglucose (FDG) positons emission tomography (PET)-computed tomography (CT) is used in many ways at baseline and during the treatment of patients with Hodgkin lymphoma. Many properties of the technique are used in the different steps of patient's management. Initial staging with PET-CT is more accurate than conventional imaging and PET-CT also became the gold standard imaging at the end of treatment with a negative PET-CT mandatory for reaching a complete remission. Early assessment of response by PET-CT is one of the most powerful prognostic factors for progression-free survival of patients with localized and advanced stages and allows guiding treatment. Conversely, previous studies showed that there is no role of FDG PET-CT for the patient's follow-up.; La tomographie par émission de positrons (TEP)-tomodensitométrie au fluorodésoxyglucose est utilisée de différentes manières au moment du diagnostic et pendant le traitement des lymphomes de Hodgkin. Plusieurs particularités de la TEP sont utilisées à différentes étapes de la prise en charge des patients. Lors du bilan initial, la TEP-tomodensitométrie est plus performante que les techniques d’imageries conventionnelles, mais l’est aussi en fin de traitement, un examen normal étant indispensable pour affirmer l’obtention d’une rémission complète. L’évaluation précoce en cours de traitement est un des facteurs pronostiques les plus puissants pour la survie sans progression et pour guider le traitement dans les maladies localisées et disséminées. À l’inverse, la TEP-tomodensitométrie n’a pas de rôle dans le suivi des patients.
Published: 2018

45. Time trends of overall survival among metastatic breast cancer patients in the real-life ESME cohort

Author: Laurence Vanlemmens, Marc Debled, Christian Cailliot, Elisa Gobbini, Thomas Bachelot, Monia Ezzalfani, Christelle Jouannaud, Suzette Delaloge, Magali Lacroix-Triki, Anne Patsouris, Thierry Petit, Simone Mathoulin-Pélissier, Veronique Lorgis, William Jacot, Marie Ange Mouret-Reynier, Mathieu Robain, C. Lefeuvre-Plesse, Florence Dalenc, Audrey Lardy Cleaud, Etienne Brain, Christelle Levy, David Pérol, C. Courtinard, Véronique Diéras, Marianne Leheurteur, Lionel Uwer, Anthony Gonçalves, Jean Marc Ferrero, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR), Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe, Institut Curie [Paris]-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute Curie, Centre Léon Bérard [Lyon], Institut Curie [Saint-Cloud], Service d'Oncologie Médicale, CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), CRLC Val d'Aurelle-Paul Lamarque, CRLCC Val d'Aurelle - Paul Lamarque, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), École nationale supérieure d'architecture de Toulouse (ENSA Toulouse), Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Service d'Oncologie médicale [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Department of Medical Oncology, CRLCC Eugène Marquis (CRLCC), Centre d'Investigation Clinique - Epidemiologie Clinique / Essais Cliniques Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CRLCC Jean Godinot, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), Département de biologie et pathologie médicales [Gustave Roussy], Cancer et génôme: Bioinformatique, biostatistiques et épidémiologie d'un système complexe, MINES ParisTech - École nationale supérieure des mines de Paris-Institut Curie-Institut National de la Santé et de la Recherche Médicale (INSERM), CRLCC Haute Normandie-CRLCC Henri Becquerel, CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie Moléculaire et Stratégies Théranostiques - Clermont Auvergne (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Institut de cancérologie de l'Ouest - Paul Papin (ICO - Paul Papin), Service d'oncologie Médicale, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, Center Oscar Lambret, CRLCC Oscar Lambret, Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL), Mines Paris - PSL (École nationale supérieure des mines de Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Curie - Saint Cloud (ICSC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Université de Lille-UNICANCER
Subjects: Adult, Cancer Research, medicine.medical_specialty, Multivariate analysis, Time Factors, Receptor, ErbB-2, [SDV.CAN]Life Sciences [q-bio]/Cancer, Breast Neoplasms, Triple Negative Breast Neoplasms, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Cancer Survivors, Risk Factors, HER2, Internal medicine, polycyclic compounds, Overall survival, Biomarkers, Tumor, Medicine, Humans, 030212 general & internal medicine, Neoplasm Metastasis, skin and connective tissue diseases, Aged, Retrospective Studies, Subtypes, Aged, 80 and over, business.industry, Time trends, Hazard ratio, Middle Aged, Metastatic breast cancer, medicine.disease, Confidence interval, 3. Good health, Treatment Outcome, Oncology, Receptors, Estrogen, 030220 oncology & carcinogenesis, Cohort, Observational study, Female, France, business, Receptors, Progesterone
Abstract: Real-life analysis of overall survival (OS) trends among metastatic breast cancer (MBC) patients may help define medical needs and evaluate the impact of public health investments. The present study aimed to evaluate the independent impact of the year of MBC diagnosis on OS in the Epidemio-Strategy-Medical-Economical (ESME)-MBC cohort.ESME-MBC (NCT03275311) is a French, national, multicentre, observational cohort including 16,702 consecutive newly diagnosed MBC patients (01 January 2008-31 December 2014). Of 16,680 eligible patients, 15,085 had full immunohistochemistry data, allowing classification as hormone receptor-positive and HER2-negative (HR+/HER2-, N = 9907), HER2-positive (HER2+, N = 2861) or triple-negative (HR-/HER2-, N = 2317) subcohorts. Multivariate analyses of OS were conducted among the full ESME cohort and subcohorts.Median OS of the whole cohort was 37.22 months (95% confidence interval [CI], 36.3-38.04). Year of diagnosis was an independent predictor of OS (hazard ratio 0.98 [95% CI, 0.97-1.00], P = .01) together with age, subtype, disease-free interval, visceral metastases and number of organs involved. Median OS of HR+/HER2-, HER2+ and HR-/HER2- subcohorts was, respectively, 42.12 (95% CI, 40.90-43.10), 44.91 (95% CI, 42.51-47.90) and 14.52 (95% CI, 13.70-15.24) months. Year of diagnosis was a strong independent predictor of OS in HER2+ subcohort (hazard ratio 0.91 [95% CI, 0.88-0.94], P .001), but not in HR+/HER2- nor HR-/HER2- subcohorts (hazard ratio 1.00 [95% CI, 0.98-1.01], P = .80 and 1.00 [95% CI, 0.97-1.02], P = .90, respectively).The OS of MBC patients has slightly improved over the past decade. However, this effect is confined to HER2+ cases, highlighting the need of new strategies in the other subtypes.
Published: 2018

46. Semi-automatic lymphoma detection and segmentation using fully conditional random fields

Author: Pierre Vera, Pierre Decazes, Isabelle Gardin, Yuntao Yu, Jerome Lapuyade-Lahorgue, Su Ruan, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), and Normandie Université (NU)
Subjects: Conditional random field, Fully connected conditional random fields, Lymphoma, Computer science, [SDV]Life Sciences [q-bio], Health Informatics, Dice, [SDV.CAN]Life Sciences [q-bio]/Cancer, 02 engineering and technology, Field (computer science), 030218 nuclear medicine & medical imaging, Set (abstract data type), 03 medical and health sciences, 0302 clinical medicine, Atlases as Topic, 0202 electrical engineering, electronic engineering, information engineering, medicine, Image Processing, Computer-Assisted, Humans, Radiology, Nuclear Medicine and imaging, Segmentation, Anatomy, Artistic, CRFS, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Conditional probability, Pattern recognition, Computer Graphics and Computer-Aided Design, 3. Good health, Anatomical atlas, Positron emission tomography, Positron-Emission Tomography, Positron Emission Tomography (PET), 020201 artificial intelligence & image processing, Computer Vision and Pattern Recognition, Artificial intelligence, business, Lymphoma detection and segmentation, Algorithms
Abstract: International audience; The detection and delineation of the lymphoma volume are a critical step for its treatment and its outcome prediction. Positron Emission Tomography (PET) is widely used for lymphoma detection. Two common types of approaches can be distinguished for lymphoma detection and segmentation in PET. The first one is ROI dependent which needs a ROI defined by physicians. The second one is based on machine learning methods which need a large learning database. However, such a large standard database is quite rare in medical field. Considering these problems, we propose a new approach that combines PET (metabolic information) with CT (anatomical information). Our approach is semi-automatic, it consists of three steps. First, an anatomical multi-atlas segmentation is applied on CT to locate and remove the organs having physiologic hypermetabolism in PET. Then, CRFs (Conditional Random Fields) detect and segment a set of possible lymphoma volumes in PET. The conditional probabilities used in CRFs are usually estimated by a learning step. In this work, we propose to estimate them in an unsupervised way. The final step is to visualize the detected lymphoma volumes and select the real ones by simply clicking on them. The false detection is low thanks to the first step. Our method is tested on 11 patients. The rate of good detection of lymphoma is 100%. The average of Dice indexes for measuring the lymphoma segmentation performance is 84.4% compared to the manual lymphoma segmentation. Comparing with other methods in terms of Dice index shows the best performance of our method.
Published: 2018

47. Added value of 18 F-florbetaben amyloid PET in the diagnostic workup of most complex patients with dementia in France: A naturalistic study

Author: Ceccaldi, Mathieu, Jonveaux, Thérèse, Verger, Antoine, Krolak-Salmon, Pierre, Houzard, Claire, Godefroy, Olivier, Shields, Trevor, Perrotin, Audrey, Gismondi, Rossella, Bullich, Santiago, Jovalekic, Aleksandar, Raffa, Nicola, Pasquier, Florence, Semah, Franck, Dubois, Bruno, Habert, Marie-Odile, Wallon, David, Chastan, Mathieu, Payoux, Pierre, Felician, Olivier, Didic, Mira, Gueriot, Claude, Koric, Lejla, Kletchkova-Gantchev, Radka, Andriuta, Daniela, Devendeville, Agnès, Dupuis, Diane, Binot, Ingrid, Barbay, Mélanie, Meyer, Marc-Etienne, Moullard, Véronique, Magnin, Eloi, Chamard, Ludivine, Haffen, Sophie, Drouet, Clément, Boulahdour, Hatem, Goas, Philippe, Querellou-Lefranc, Solène, de La Sayette, Vincent, Cogez, Julien, Branger, Pierre, Agostini, Denis, Manrique, Alain, Bejot, Yannick, Jacquin-Piques, Agnès, Dygai-Cochet, Inna, Berriolo-Riedinger, Alina, Moreaud, Olivier, Sauvee, Mathilde, Crépin, Céline, Bombois, Stéphanie, Lebouvier, Thibaud, Mackowiak-Cordoliani, Marie-Anne, Deramecourt, Vincent, Rollin-Sillaire, Adeline, Cassagnaud-Thuillet, Pascaline, Chen, Yaohua, Petyt, Grégory, Federico, Denis, Danaila, Keren, Guilhermet, Yves, Magnier, Christophe, Makaroff, Zaza, Rouch, Isabelle, Xie, Jing, Roubaud, Caroline, Coste, Marie-Hélène, David, Kenny, Sarciron, Alain, Waissi, Aziza, Scheiber, Christian, Gabelle-Deloustal, Audrey, Bennys, Karim, Marelli, Cecilia, Touati, Lynda, de Verbizier-Lonjon, Delphine, Benetos, Athanase, Kearney-Schwartz, Anna, Perret-Guillaume, Christine, Vercelletto, Martine, Boutoleau-Bretonniere, Claire, Pouclet-Courtemanche, Hélène, Wagemann, Nathalie, Pallardy, Amandine, Hugon, Jacques, Paquet, Claire, Dumurgier, Julien, Millet, Pascal, Queneau, Mathieu, Epelbaum, Stéphane, Levy, Marcel, Novella, Jean-Luc, Jaidi, Yacine, Morland, David, Belliard, Serge, Salmon, Anne, Lejeune, Florence, Hannequin, Didier, Martinaud, Olivier, Zarea, Aline, Pariente, Jérémie, Thalamas, Claire, Galitzky-Gerber, Monique, Tricoire Ricard, Anne-Marie, Calvas, Fabienne, Rigal, Emilie, Hitzel, Anne, Delrieu, Julien, Ousset, Pierre-Jean, Lala, Françoise, Sastre-Hengan, Nathalie, Morel, Olivier, Rouaud, Olivier, Mariano-Goulart, Denis, Papathanassiou, Dimitri, Le Jeune, Florence, Stephens, Andrew, Guedj, Eric, Hôpital de la Timone [CHU - APHM] (TIMONE), Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gériatrie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Service de neurologie [Amiens], CHU Amiens-Picardie, Service de Médecine Nucléaire [Amiens], Piramal Imaging, Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Troubles cognitifs vasculaires et dégénératifs, Université de Lille, Sciences et Technologies, Institut de la Mémoire et de la Maladie d'Alzheimer [Paris] (IM2A), Sorbonne Université (SU), Laboratoire d'Imagerie Biomédicale (LIB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-CRLCC Henri Becquerel, Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Neurobiologie intégrative et adaptative (NIA), Université de Provence - Aix-Marseille 1-Centre National de la Recherche Scientifique (CNRS), Service de neurologie et de neuropsychologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Université de Picardie Jules Verne (UPJV), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Université de Bourgogne (UB), Université de Lorraine (UL), Nanomédecine, imagerie, thérapeutique - UFC (EA 4662) (NIT / NANOMEDECINE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de neurologie, Centre Hospitalier Universitaire [Grenoble] (CHU), Service de Neurologie [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Neuropsychologie cognitive et neuroanatomie fonctionnelles de la mémoire humaine, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe coeur et ischémie, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Service de médecine nucléaire [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Optimisation - Système - Energie (GEPEA-OSE), Laboratoire de génie des procédés - environnement - agroalimentaire (GEPEA), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes (UN)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes (UN)-Centre National de la Recherche Scientifique (CNRS), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Médecine Nucléaire, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Pôle Psychiatrie et Neurologie [Grenoble], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Neuroendocrinologie et physiopathologie neuronale, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Département de neurologie[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital des Charpennes [CHU - HCL], CEA Le Ripault (CEA Le Ripault), Direction des Applications Militaires (DAM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Unité de Gériatrie, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre Mémoire de Ressources et de Recherche (CMRR Lyon), Système Nerveux Autonome - Epidémiologie, Physiologie, Ingénierie, Santé (SNA-EPIS), Université Jean Monnet [Saint-Étienne] (UJM)-Centre Hospitalier Universitaire de Saint-Etienne, Institut Jacques Monod (IJM (UMR_7592)), Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Gérontologie [CHRU Nancy], Clinique neurologique, Hôpital Laennec, Service de neurologie [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Service de Médecine Nucléaire [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Neurologie Cognitive [Paris], Université Paris Diderot - Paris 7 (UPD7)-Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Parasitologie-Immunologie (EA 3677), Université Bordeaux Segalen - Bordeaux 2, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), Hôpital de Reims - Service de neuro-gériatrie, Hôpital de Reims, Service de neurologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service de médecine nucléaire [Rennes], CRLCC Eugène Marquis (CRLCC), Génétique médicale et fonctionnelle du cancer et des maladies neuropsychiatriques, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - Biotherapie - Toulouse, CHU Clermont-Ferrand, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Gérontopôle, Department of Geriatrics, Centre Hospitalier Universitaire de Toulouse, Troubles cognitifs dégénératifs et vasculaires (U1171), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-INSERM, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Bureau de Recherches Géologiques et Minières (BRGM) (BRGM), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Franche-Comté (UFC), École pratique des hautes études (EPHE)-Université de Caen Normandie (UNICAEN), Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université Paris Diderot - Paris 7 (UPD7)-Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire d'Imagerie Biomédicale [Paris] (LIB), CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Service d'Obstétrique et de Gynécologie [CHRU Nancy], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Sciences et Technologies de l'Information et de la Communication - EA 3804 (CRESTIC), Université de Reims Champagne-Ardenne (URCA), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR), H. Lundbeck A/S, Novartis, Roche, Pfizer, Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Université de Nantes (UN)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Ecole Polytechnique de l'Université de Nantes (EPUN), Université de Nantes (UN)-Université de Nantes (UN)-Institut Universitaire de Technologie - Nantes (IUT Nantes), Université de Nantes (UN)-Institut Universitaire de Technologie Saint-Nazaire (IUT Saint-Nazaire), Université de Nantes (UN)-Institut Universitaire de Technologie - La Roche-sur-Yon (IUT La Roche-sur-Yon), Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL)-Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pontchaillou [Rennes]-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-Institut des Neurosciences Cliniques de Rennes (INCR)
Subjects: 0301 basic medicine, NATIONAL INSTITUTE, Pathology, Epidemiology, IMPACT, Amyloid pet, Clinical practice, BETA PLAQUES, 0302 clinical medicine, MESH: Stilbenes, Diagnosis, MESH: Aged, UTILITY, medicine.diagnostic_test, Health Policy, Alzheimer's disease, MESH: Dementia, MESH: Positron-Emission Tomography, 3. Good health, ALZHEIMERS-DISEASE, Psychiatry and Mental health, Positron emission tomography, Radiology, MESH: Radiopharmaceuticals, medicine.medical_specialty, CSF BIOMARKERS, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Amyloid imaging, 18F-florbetaben, MESH: Aniline Compounds, 03 medical and health sciences, Cellular and Molecular Neuroscience, MESH: Brain, Naturalistic observation, SCANS, Developmental Neuroscience, MESH: Diagnosis, Differential, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, MANAGEMENT, Dementia, Florbetaben, MESH: Amyloid, MESH: Humans, business.industry, medicine.disease, MESH: Male, MESH: France, 030104 developmental biology, Multicenter study, Etiology, Patient management, Neurology (clinical), Geriatrics and Gerontology, business, MESH: Female, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Introduction: Although some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical implementation in relation to cerebrospinal fluid analysis in a naturalistic setting.Methods: This multicenter study was performed at French tertiary memory clinics in patients presenting with most complex clinical situations (i.e., early-onset, atypical clinical profiles, suspected mixed etiological conditions, unexpected rate of progression), for whom cerebrospinal fluid analysis was indicated but either not feasible or considered as noncontributory (ClinicalTrials.gov: NCT02681172).Results: Two hundred five patients were enrolled with evaluable florbetaben PET scans; 64.4% of scans were amyloid positive. PET results led to changed diagnosis and improved confidence in 66.8% and 81.5% of patients, respectively, and altered management in 80.0% of cases.Discussion: High-level improvement of diagnostic certainty and management is provided by selective and hierarchical implementation of florbetaben PET into current standard practices for the most complex dementia cases. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.
Published: 2018

48. Tumor fragmentation estimated by volume surface ratio of tumors measured on 18F-FDG PET/CT is an independent prognostic factor of diffuse large B-cell lymphoma

Author: Pierre Vera, Paul Desbordes, Isabelle Gardin, Mathieu Nessim Toledano, Hervé Tilly, Stéphanie Becker, Pierre Decazes, Fabrice Jardin, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Prognostic factor, [SDV]Life Sciences [q-bio], Tumor burden, Kaplan-Meier Estimate, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Fragmentation (cell biology), ComputingMilieux_MISCELLANEOUS, Neoplasm Staging, Retrospective Studies, medicine.diagnostic_test, business.industry, General Medicine, Middle Aged, medicine.disease, Prognosis, Lymphoma, Tumor Burden, Volume (thermodynamics), ROC Curve, Positron emission tomography, 030220 oncology & carcinogenesis, Multivariate Analysis, Fdg pet ct, Female, Lymphoma, Large B-Cell, Diffuse, business, Nuclear medicine, Diffuse large B-cell lymphoma
Abstract: Our aim was to study the prognostic value of two newWe retrospectively included 215 patients with DLBCL. Patients underwent initialTVSR was poorly correlated with TMTV (ρ = 0.5) and TTS (ρ = 0.26), while TTS was highly correlated with TMTV (ρ = 0.94) and was, therefore, excluded from the analysis. TMTV had the highest area under the ROC curve (0.711) and the best sensitivity (0.797), while TVSR had the best specificity (0.745). The optimal cut-off values to predict 5-year OS were 222 cmTVSR measured on the initial
Published: 2018

49. Spatial Evidential Clustering with Adaptive Distance Metric for Tumor Segmentation in FDG-PET Images

Author: Pierre Vera, Thierry Denoux, Su Ruan, Chunfeng Lian, Hua Li, Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Heuristique et Diagnostic des Systèmes Complexes [Compiègne] (Heudiasyc), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Service de médecine nucléaire [Rouen], and CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: Lung Neoplasms, Feature extraction, Correlation clustering, Biomedical Engineering, ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION, Feature selection, 02 engineering and technology, computer.software_genre, Electronic mail, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Voxel, Carcinoma, Non-Small-Cell Lung, Image Interpretation, Computer-Assisted, 0202 electrical engineering, electronic engineering, information engineering, Cluster Analysis, Humans, Computer vision, Cluster analysis, Mathematics, business.industry, Pattern recognition, Image segmentation, Positron-Emission Tomography, Metric (mathematics), 020201 artificial intelligence & image processing, Artificial intelligence, business, computer, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Algorithms
Abstract: While the accurate delineation of tumor volumes in FDG-positron emission tomography (PET) is a vital task for diverse objectives in clinical oncology, noise and blur due to the imaging system make it a challenging work. In this paper, we propose to address the imprecision and noise inherent in PET using Dempster-Shafer theory, a powerful tool for modeling and reasoning with uncertain and/or imprecise information. Based on Dempster-Shafer theory, a novel evidential clustering algorithm is proposed and tailored for the tumor segmentation task in three-dimensional. For accurate clustering of PET voxels, each voxel is described not only by the single intensity value but also complementarily by textural features extracted from a patch surrounding the voxel. Considering that there are a large amount of textures without consensus regarding the most informative ones, and some of the extracted features are even unreliable due to the low-quality PET images, a specific procedure is included in the proposed clustering algorithm to adapt distance metric for properly representing the clustering distortions and the similarities between neighboring voxels. This integrated metric adaptation procedure will realize a low-dimensional transformation from the original space, and will limit the influence of unreliable inputs via feature selection. A Dempster-Shafer-theory-based spatial regularization is also proposed and included in the clustering algorithm, so as to effectively quantify the local homogeneity. The proposed method has been compared with other methods on the real-patient FDG-PET images, showing good performance.
Published: 2018

50. How to use PET/CT in the evaluation of response to radiotherapy

Author: Bernard Dubray, Pierre Vera, Pierre Decazes, Sébastien Thureau, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU), Département de radiothérapie et de physique médicale, and Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
Subjects: medicine.medical_specialty, Palliative care, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Rectum, [SDV.CAN]Life Sciences [q-bio]/Cancer, Multimodal Imaging, 030218 nuclear medicine & medical imaging, Choline, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Fluorodeoxyglucose F18, Neoplasms, Positron Emission Tomography Computed Tomography, Medicine, Humans, Radiology, Nuclear Medicine and imaging, PET-CT, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Radiation therapy, medicine.anatomical_structure, Treatment Outcome, Positron emission tomography, 030220 oncology & carcinogenesis, Radiology, Radiopharmaceuticals, business
Abstract: International audience; Radiotherapy is a major treatment modality for many cancers. Tumor response after radiotherapy determines the subsequent steps of the patient's management (surveillance, adjuvant or salvage treatment and palliative care). Tumor response assessed during radiotherapy offers a promising opportunity to adapt the treatment plan to reduced or increased target volume, to specifically target sub-volumes with relevant biological characteristics (metabolism, hypoxia, proliferation, etc.) and to further spare the organs at risk. In addition to its role in the diagnosis and the initial staging, Positron Emission Tomography combined with a Computed Tomography (PET/CT) provides functional information and is therefore attractive to evaluate tumor response. The aim of this paper is to review the published data addressing PET/CT as an evaluation tool in irradiated tumors. Reports on PET/CT acquired at various times (during radiotherapy, after initial (chemo-) radiotherapy, after definitive radiotherapy and during posttreatment follow-up) in solid tumors (lung, head-and-neck, cervix, esophagus, prostate and rectum) were collected and reviewed. Various tracers and technical aspects are also discussed. 18F-FDG PET/CT has a well-established role in clinical routine after definitive chemo-radiotherapy for locally advanced head-and-neck cancers. 18F-choline PET/CT is indicated in prostate cancer patients with biochemical failure. 18F-FDG PET/CT is optional in many other circumstances and the clinical benefits of assessing tumor response with PET/CT remain a field of very active research. The combination of PET with Magnetic Resonance Imaging (PET/MRI) may prove to be valuable in irradiated rectal and cervix cancers. Tumor response can be evaluated by PET/CT with clinical consequences in multiple situations, notably in head and neck and prostate cancers, after radiotherapy. Further clinical evaluation for most cancers is still needed, possibly in association to MRI.
Published: 2017

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