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Kifjak D, El Kaddouri B, Madani SP, de Margerie-Mellon C, Heidinger BH. From text to texture: a glossary transforms the pulmonary nodule paradigm. Eur Radiol 2024:10.1007/s00330-024-10763-y. [PMID: 38649472 DOI: 10.1007/s00330-024-10763-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/10/2024] [Accepted: 03/20/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Daria Kifjak
- Department of Radiology, University of Massachusetts Memorial Health and University of Massachusetts Chan Medical School, Worcester, MA, USA.
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
| | - Bilal El Kaddouri
- Department of Radiology, University of Massachusetts Memorial Health and University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Radiology, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Seyedeh Panid Madani
- Department of Radiology, University of Massachusetts Memorial Health and University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Benedikt H Heidinger
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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de Margerie-Mellon C. Leveraging artificial intelligence in radiology education: challenges and opportunities. Eur Radiol 2023; 33:8239-8240. [PMID: 37581666 DOI: 10.1007/s00330-023-10112-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Constance de Margerie-Mellon
- Université Paris Cité, PARCC UMRS 970, INSERM, Paris, France.
- Department of Radiology, Hôpital Saint-Louis APHP, Paris, France.
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3
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de Margerie-Mellon C, Chassagnon G. Artificial intelligence: A critical review of applications for lung nodule and lung cancer. Diagn Interv Imaging 2023; 104:11-17. [PMID: 36513593 DOI: 10.1016/j.diii.2022.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022]
Abstract
Artificial intelligence (AI) is a broad concept that usually refers to computer programs that can learn from data and perform certain specific tasks. In the recent years, the growth of deep learning, a successful technique for computer vision tasks that does not require explicit programming, coupled with the availability of large imaging databases fostered the development of multiple applications in the medical imaging field, especially for lung nodules and lung cancer, mostly through convolutional neural networks (CNN). Some of the first applications of AI is this field were dedicated to automated detection of lung nodules on X-ray and computed tomography (CT) examinations, with performances now reaching or exceeding those of radiologists. For lung nodule segmentation, CNN-based algorithms applied to CT images show excellent spatial overlap index with manual segmentation, even for irregular and ground glass nodules. A third application of AI is the classification of lung nodules between malignant and benign, which could limit the number of follow-up CT examinations for less suspicious lesions. Several algorithms have demonstrated excellent capabilities for the prediction of the malignancy risk when a nodule is discovered. These different applications of AI for lung nodules are particularly appealing in the context of lung cancer screening. In the field of lung cancer, AI tools applied to lung imaging have been investigated for distinct aims. First, they could play a role for the non-invasive characterization of tumors, especially for histological subtype and somatic mutation predictions, with a potential therapeutic impact. Additionally, they could help predict the patient prognosis, in combination to clinical data. Despite these encouraging perspectives, clinical implementation of AI tools is only beginning because of the lack of generalizability of published studies, of an inner obscure working and because of limited data about the impact of such tools on the radiologists' decision and on the patient outcome. Radiologists must be active participants in the process of evaluating AI tools, as such tools could support their daily work and offer them more time for high added value tasks.
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Affiliation(s)
- Constance de Margerie-Mellon
- Université Paris Cité, Laboratory of Imaging Biomarkers, Center for Research on Inflammation, UMR 1149, INSERM, 75018 Paris, France; Department of Radiology, Hôpital Saint-Louis APHP, 75010 Paris, France
| | - Guillaume Chassagnon
- Université Paris Cité, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Hôpital Cochin APHP, 75014 Paris, France
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4
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Amouyal G, Tournier L, de Margerie-Mellon C, Bouda D, Pachev A, Assouline J, de Bazelaire C, Marques F, Le Strat S, Desgrandchamps F, De Kerviler E. Feasibility of Outpatient Transradial Prostatic Artery Embolization and Safety of a Shortened Deflation Protocol for Hemostasis. J Pers Med 2022; 12:jpm12071138. [PMID: 35887635 PMCID: PMC9316516 DOI: 10.3390/jpm12071138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background: to evaluate the safety and feasibility of a shorter time to hemostasis applied to outpatient transradial (TR) Prostatic Artery Embolization (PAE). Methods: a retrospective bi-institutional study was conducted between July 2018 and April 2022 on 300 patients treated by outpatient TR PAE. Indications included lower urinary tract symptoms, acute urinary retention, and hematuria. Mean patient height was 176 ± 6.3 (158–192) cm. The primary endpoint was safety of a 45 min deflation protocol for hemostasis. The secondary endpoint was the feasibility of PAE using TR access. Results: technical success was 98.7% (296/300). There was one failure due to patient height. Mean DAP/fluoroscopy times were 16,225 ± 12,126.3 (2959–81,608) μGy·m2/35 ± 14.7 (11–97) min, and mean time to discharge was 80 ± 6 (75–90) min. All access site and embolization-related adverse events were minor. Mild hematoma occurred in 10% (30/300), radial artery occlusion (RAO) in 10/300 (3.3%) cases, and history of smoking was a predictor for RAO. There was no major event. Conclusion: the safety of TR PAE using a 45 min time to hemostasis was confirmed, and TR PAE is feasible in most cases. Radial artery occlusion was still observed and may be favored by smoking.
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Affiliation(s)
- Gregory Amouyal
- Hôpital Privé Geoffroy Saint-Hilaire—Ramsay Santé, 75005 Paris, France; (F.M.); (S.L.S.)
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Correspondence: ; Tel.: +33-670132138
| | - Louis Tournier
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
| | - Constance de Margerie-Mellon
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
| | - Damien Bouda
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
| | - Atanas Pachev
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
| | - Jessica Assouline
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
| | - Cédric de Bazelaire
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
| | - Florent Marques
- Hôpital Privé Geoffroy Saint-Hilaire—Ramsay Santé, 75005 Paris, France; (F.M.); (S.L.S.)
| | - Solenne Le Strat
- Hôpital Privé Geoffroy Saint-Hilaire—Ramsay Santé, 75005 Paris, France; (F.M.); (S.L.S.)
| | - François Desgrandchamps
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
- Urology Department, Hôpital Saint-Louis, 75010 Paris, France
- SRHI/CEA—Institut de Recherche Clinique Saint-Louis, Hôpital Saint-Louis, 75010 Paris, France
| | - Eric De Kerviler
- Radiology Department, Hôpital Saint-Louis, 75010 Paris, France; (L.T.); (C.d.M.-M.); (D.B.); (A.P.); (J.A.); (C.d.B.); (E.D.K.)
- Faculté de Médecine, Université Paris cité, 75006 Paris, France;
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Dadoun H, Rousseau AL, de Kerviler E, Correas JM, Tissier AM, Joujou F, Bodard S, Khezzane K, de Margerie-Mellon C, Delingette H, Ayache N. Deep Learning for the Detection, Localization, and Characterization of Focal Liver Lesions on Abdominal US Images. Radiol Artif Intell 2022; 4:e210110. [PMID: 35652113 DOI: 10.1148/ryai.210110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 02/08/2022] [Accepted: 02/16/2022] [Indexed: 12/24/2022]
Abstract
Purpose To train and assess the performance of a deep learning-based network designed to detect, localize, and characterize focal liver lesions (FLLs) in the liver parenchyma on abdominal US images. Materials and Methods In this retrospective, multicenter, institutional review board-approved study, two object detectors, Faster region-based convolutional neural network (Faster R-CNN) and Detection Transformer (DETR), were fine-tuned on a dataset of 1026 patients (n = 2551 B-mode abdominal US images obtained between 2014 and 2018). Performance of the networks was analyzed on a test set of 48 additional patients (n = 155 B-mode abdominal US images obtained in 2019) and compared with the performance of three caregivers (one nonexpert and two experts) blinded to the clinical history. The sign test was used to compare accuracy, specificity, sensitivity, and positive predictive value among all raters. Results DETR achieved a specificity of 90% (95% CI: 75, 100) and a sensitivity of 97% (95% CI: 97, 97) for the detection of FLLs. The performance of DETR met or exceeded that of the three caregivers for this task. DETR correctly localized 80% of the lesions, and it achieved a specificity of 81% (95% CI: 67, 91) and a sensitivity of 82% (95% CI: 62, 100) for FLL characterization (benign vs malignant) among lesions localized by all raters. The performance of DETR met or exceeded that of two experts and Faster R-CNN for these tasks. Conclusion DETR demonstrated high specificity for detection, localization, and characterization of FLLs on abdominal US images. Supplemental material is available for this article. RSNA, 2022Keywords: Computer-aided Diagnosis (CAD), Ultrasound, Abdomen/GI, Liver, Tissue Characterization, Supervised Learning, Transfer Learning, Convolutional Neural Network (CNN).
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Affiliation(s)
- Hind Dadoun
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Anne-Laure Rousseau
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Eric de Kerviler
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Jean-Michel Correas
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Anne-Marie Tissier
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Fanny Joujou
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Sylvain Bodard
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Kemel Khezzane
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Constance de Margerie-Mellon
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Hervé Delingette
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
| | - Nicholas Ayache
- Université Côte d'Azur, Inria, Epione Team, Sophia Antipolis, 2004 Route des Lucioles, 06902 Valbonne, France (H. Dadoun, H. Delingette, N.A.); Department of Vascular Surgery, Georges Pompidou European Hospital APHP, Université de Paris, Paris, France (A.L.R.); NHance.ngo, Saint Germain en Laye, France (A.L.R.); Department of Radiology, Hôpital Saint Louis APHP, Université de Paris, Paris, France (E.d.K., F.J., K.K., C.d.M.M.); and Department of Adult Radiology, Université de Paris and Université de l'Hôpital Necker, Paris, France (J.M.C., A.M.T., S.B.)
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Benattia A, Bugnet E, Walter-Petrich A, de Margerie-Mellon C, Meignin V, Seguin-Givelet A, Lorillon G, Chevret S, Tazi A. Long-term Outcomes of Adult Pulmonary Langerhans Cell Histiocytosis: A Prospective Cohort. Eur Respir J 2021; 59:13993003.01017-2021. [PMID: 34675043 DOI: 10.1183/13993003.01017-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/02/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND The long-term outcomes of adult pulmonary Langerhans cell histiocytosis (PLCH), particularly survival, are largely unknown. Two earlier retrospective studies reported a high rate of mortality, which contrasts with our clinical experience. METHODS To address this issue, all newly diagnosed PLCH patients referred to the French national reference centre for histiocytoses between 2004 and 2018 were eligible for inclusion. The primary outcome was survival, which was defined as the time from inclusion to lung transplantation or death from any cause. Secondary outcomes included the cumulative incidences of chronic respiratory failure (CRF), pulmonary hypertension (PH), malignant diseases, and extra-pulmonary involvement in initially isolated PLCH. Survival was estimated using the Kaplan-Meier method. RESULTS Two hundred six patients (mean age: 39±13 years, 60% females, 95% current smokers) were prospectively followed for a median duration of 5.1 years (interquartile range [IQR], 3.2 to 7.6). Twelve (6%) patients died. The estimated rate of survival at 10 years was 93% (95% confidence interval [CI], 89-97). The cumulative incidences of CRF and/or PH were less than 5% at both 5 and 10 years, and 58% of these patients died. Twenty-seven malignancies were observed in 23 patients. The estimated standardized incidence ratio of lung carcinoma was 17.0 (95% CI, 7.45-38.7) compared to an age- and sex-matched French population. Eight (5.1%) of the 157 patients with isolated PLCH developed extra-pulmonary involvement. CONCLUSIONS The long-term prognosis of PLCH is significantly more favourable than was previously reported. Patients must be closely monitored after diagnosis to detect severe complications early.
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Affiliation(s)
- Amira Benattia
- Centre National de Référence des Histiocytoses, Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Emmanuelle Bugnet
- Centre National de Référence des Histiocytoses, Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Anouk Walter-Petrich
- Biostatistics and Clinical Epidemiology Research Team (ECSTRRA), INSERM UMR-1153 (CRESS), Université de Paris, Paris, France.,Service de Biostatistique et Information Médicale, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Constance de Margerie-Mellon
- Université de Paris, INSERM UMR-1149, Paris, France.,Service de Radiologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | | | - Agathe Seguin-Givelet
- Département Thoracique, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France
| | - Gwenaël Lorillon
- Centre National de Référence des Histiocytoses, Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Sylvie Chevret
- Biostatistics and Clinical Epidemiology Research Team (ECSTRRA), INSERM UMR-1153 (CRESS), Université de Paris, Paris, France.,Service de Biostatistique et Information Médicale, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Abdellatif Tazi
- Centre National de Référence des Histiocytoses, Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France .,Human Immunology Pathophysiology and Immunotherapy (HIPI) Unit, INSERM UMR-976, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
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7
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Kapandji N, Yvin E, Devriese M, de Margerie-Mellon C, Moratelli G, Lemiale V, Jabaudon M, Azoulay E, Constantin JM, Dumas G. Importance of Lung Epithelial Injury in COVID-19-associated Acute Respiratory Distress Syndrome: Value of Plasma Soluble Receptor for Advanced Glycation End-Products. Am J Respir Crit Care Med 2021; 204:359-362. [PMID: 34033529 PMCID: PMC8513587 DOI: 10.1164/rccm.202104-1070le] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Elise Yvin
- Hôpital Saint-Louis Paris, France.,Université de Paris Paris, France
| | - Magali Devriese
- Hôpital Saint-Louis Paris, France.,Université de Paris Paris, France
| | | | | | | | - Matthieu Jabaudon
- CHU ClermontFerrand and Université Clermont Auvergne ClermontFerrand, France
| | - Elie Azoulay
- Hôpital Saint-Louis Paris, France.,Université de Paris Paris, France
| | | | - Guillaume Dumas
- Hôpital Saint-Louis Paris, France.,Université de Paris Paris, France
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8
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Revel MP, Boussouar S, de Margerie-Mellon C, Saab I, Lapotre T, Mompoint D, Chassagnon G, Milon A, Lederlin M, Bennani S, Molière S, Debray MP, Bompard F, Dangeard S, Hani C, Ohana M, Bommart S, Jalaber C, El Hajjam M, Petit I, Fournier L, Khalil A, Brillet PY, Bellin MF, Redheuil A, Rocher L, Bousson V, Rousset P, Grégory J, Deux JF, Dion E, Valeyre D, Porcher R, Jilet L, Abdoul H. Study of Thoracic CT in COVID-19: The STOIC Project. Radiology 2021; 301:E361-E370. [PMID: 34184935 PMCID: PMC8267782 DOI: 10.1148/radiol.2021210384] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background There are conflicting data regarding the diagnostic performance of Chest computed tomography (CT) for COVID-19 pneumonia. Disease extent on CT has been reported to influence prognosis. Purpose To create a large publicly available dataset and assess the diagnostic and prognostic value of CT in COVID-19 pneumonia. Materials and Methods This multicenter observational retrospective cohort study (ClinicalTrials.gov: NCT04355507) involved 20 French university hospitals. Eligible subjects presented at the emergency departments of the hospitals involved between March 1st and April 30th, 2020 and underwent both thoracic CT and RT-PCR for suspected COVID-19 pneumonia. CT images were read blinded to initial reports, RT-PCR, demographic characteristics, clinical symptoms, and outcome. Readers classified CT scans as positive or negative for COVID-19, based on criteria published by the French Society of Radiology. Multivariable logistic regression was used to develop a model predicting severe outcome (intubation or death) at 1-month follow-up in subjects positive for both RT-PCR and CT, using clinical and radiological features. Results Of 10,930 subjects screened for eligibility, 10,735 (median age 65 years, interquartile range, 51-77 years; 6,147 men) were included and 6,448 (60.0%) had a positive RT-PCR result. With RT-PCR as reference, the sensitivity and specificity and CT were 80.2% (95%CI: 79.3, 81.2) and 79.7% (95%CI: 78.5, 80.9), respectively with strong agreement between junior and senior radiologists (Gwet's AC1 coefficient: 0.79) Of all the variables analysed, the extent of pneumonia on CT (OR 3.25, 95%CI: 2.71, 3.89) was the best predictor of severe outcome at one month. A score based solely on clinical variables predicted a severe outcome with an AUC of 0.64 (95%CI: 0.62, 0.66), improving to 0.69 (95%CI: 0.6, 0.71) when it also included the extent of pneumonia and coronary calcium score on CT. Conclusion Using pre-defined criteria, CT reading is not influenced by reader's experience and helps predict the outcome at one month. Published under a CC BY 4.0 license. See also the editorial by Rubin.
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Affiliation(s)
- Marie-Pierre Revel
- Université de Paris, APHP, Hôpital Cochin, Dept of Radiology, Paris, France
| | - Samia Boussouar
- Sorbonne Université, APHP, Hôpital Pitié Salpétrière, Dept of Radiology, Paris, France
| | | | - Inès Saab
- Université de Paris, APHP, Hôpital Cochin, Dept of Radiology, Paris, France
| | - Thibaut Lapotre
- Université Rennes1, Hôpital Pontchaillou, Dept of Radiology, Rennes, France
| | - Dominique Mompoint
- Université Paris-Saclay, APHP, Hôpital Raymond Poincaré, Dept of Radiology, Garches, France
| | | | - Audrey Milon
- Sorbonne Université, APHP, Hôpital Tenon, Dept of Radiology, Paris, France
| | - Mathieu Lederlin
- Université Rennes1, Hôpital Pontchaillou, Dept of Radiology, Rennes, France
| | - Souhail Bennani
- Université de Paris, APHP, Hôpital Cochin, Dept of Radiology, Paris, France
| | - Sébastien Molière
- Université de Strasbourg, Hôpital de Hautepierre, Dept of Radiology, Strasbourg, France
| | | | - Florian Bompard
- Université de Paris, APHP, Hôpital Cochin, Dept of Radiology, Paris, France
| | - Severine Dangeard
- Université de Paris, APHP, Hôpital Cochin, Dept of Radiology, Paris, France
| | - Chahinez Hani
- Université de Paris, APHP, Hôpital Cochin, Dept of Radiology, Paris, France
| | - Mickaël Ohana
- Université de Strasbourg, Nouvel Hôpital Civil, Dept of Radiology, Strasbourg, France
| | - Sébastien Bommart
- Université de Montpellier, Hôpital Arnaud de Villeneuve, Dept of Radiology, Montpellier France
| | - Carole Jalaber
- Université de Paris, APHP, Hôpital Cochin, Dept of Radiology, Paris, France
| | - Mostafa El Hajjam
- Université Paris-Saclay, APHP, Hôpital Ambroise Paré, Dept of Radiology, Boulogne, France
| | - Isabelle Petit
- Université de Lorraine, Hôpital Brabois, Dept of Radiology, Vandoeuvre, France
| | - Laure Fournier
- Université de Paris, APHP, Hôpital Européen Georges Pompidou, Dept of Radiology, INSERM U970, PARCC, Paris, France
| | - Antoine Khalil
- Université de Paris, APHP, Hôpital Bichat, Dept of Radiology, Paris, France
| | - Pierre-Yves Brillet
- Sorbonne Université, APHP, Hôpital Avicenne, Dept of Radiology, Bobigny, France
| | - Marie-France Bellin
- Université Paris-Saclay, APHP, Hôpital Bicêtre, Dept of Radiology, Le Kremlin-Bicêtre, France
| | - Alban Redheuil
- Sorbonne Université, APHP, Hôpital Pitié Salpétrière, Dept of Radiology, Paris, France
| | - Laurence Rocher
- Université Paris-Saclay, APHP, Hôpital Antoine Béclère, Dept of Radiology, Clamart, France
| | - Valérie Bousson
- Université de Paris, APHP, Hôpital Lariboisière, Dept of Radiology, Paris, France
| | - Pascal Rousset
- Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Hôpital Lyon Sud, Dept of Radiology, Pierre-Benite, France
| | - Jules Grégory
- Université de Paris, APHP, Hôpital Beaujon, Dept of Radiology, Clichy, France
| | - Jean-François Deux
- Université Paris Est, APHP, Dept of Radiology, Hôpital Henri Mondor, Créteil, France
| | - Elisabeth Dion
- Université de Paris, APHP, Hôtel-Dieu, Dept of Radiology, Paris, France
| | - Dominique Valeyre
- Sorbonne Université, APHP, Hôpital Avicenne, Dept of Pneumology, Bobigny, INSERM UMR 1272, France
| | - Raphael Porcher
- Université de Paris, APHP, Hôtel-Dieu, Dept of Clinical Epidemiology, Paris, France
| | - Léa Jilet
- Université de Paris APHP, Clinical Research Unit Paris Centre, Paris, France
| | - Hendy Abdoul
- Université de Paris APHP, Clinical Research Unit Paris Centre, Paris, France
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Lederlin M, de Margerie-Mellon C, Boussouar S, Bommart S, Caramella C. Lung cancer screening: French radiologists should prepare for it. Diagn Interv Imaging 2021; 102:197-198. [PMID: 33642220 DOI: 10.1016/j.diii.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Mathieu Lederlin
- Department of Radiology, University Hospital of Rennes, University of Rennes, 35033 Rennes, France.
| | - Constance de Margerie-Mellon
- Department of Radiology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France; Université de Paris, 75010 Paris, France
| | - Samia Boussouar
- Department of Radiology, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne University, 75651 Paris, France
| | - Sébastien Bommart
- Department of Medical Imaging, University Hospital of Montpellier, University of Montpellier, 34295 Montpellier, France
| | - Caroline Caramella
- Department of Radiology, Hôpital Marie Lannelongue, Institut d'Oncologie Thoracique, Paris-Saclay University, 92350 Le Plessis-Robinson, France
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de Margerie-Mellon C, Debry JB, Dupont A, Cuvier C, Giacchetti S, Teixeira L, Espié M, de Bazelaire C. Nonpalpable breast lesions: impact of a second-opinion review at a breast unit on BI-RADS classification. Eur Radiol 2021; 31:5913-5923. [PMID: 33462625 DOI: 10.1007/s00330-020-07664-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/10/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare BI-RADS classification, management, and outcome of nonpalpable breast lesions assessed both by community practices and by a multidisciplinary tumor board (MTB) at a breast unit. METHODS All nonpalpable lesions that were first assigned a BI-RADS score by community practices and then reassessed by an MTB at a single breast unit from 2009 to 2017 were retrospectively reviewed. Inter-review agreement was assessed with Cohen's kappa statistic. Changes in biopsy recommendation were calculated. The percentage of additional tumor lesions detected by the MTB was obtained. The sensitivity, AUC, and cancer rates for BI-RADS category 3, 4, and 5 lesions were computed for both reviews. RESULTS A total of 1909 nonpalpable lesions in 1732 patients were included. For BI-RADS scores in the whole cohort, a fair agreement was found (κ = 0.40 [0.36-0.45]) between the two reviews. Agreement was higher when considering only mammography combined with ultrasound (κ = 0.53 [0.44-0.62]), masses (κ = 0.50 [0.44-0.56]), and architectural distortion (κ = 0.44 [0.11-0.78]). Changes in biopsy recommendation occurred in 589 cases (31%). Ninety of 345 additional biopsies revealed high-risk or malignant lesions. Overall, the MTB identified 27% additional high-risk and malignant lesions compared to community practices. The BI-RADS classification AUCs for detecting malignant lesions were 0.66 (0.63-0.69) for community practices and 0.76 (0.75-0.78) for the MTB (p < 0.001). CONCLUSION Agreement between community practices and MTB reviews for BI-RADS classification in nonpalpable lesions is only fair. MTB review improves diagnostic performances of breast imaging and patient management. KEY POINTS • The inter-review agreement for BI-RADS classification between community practices and the multidisciplinary board was only fair (κ = 0.40). • Disagreements resulted in changes of biopsy recommendation in 31% of the lesions. • The multidisciplinary board identified 27% additional high-risk and malignant lesions compared to community practices.
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Affiliation(s)
- Constance de Margerie-Mellon
- Department of Radiology, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France.
| | - Jean-Baptiste Debry
- Department of Radiology, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France
| | - Axelle Dupont
- Department of Biostatistics, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Caroline Cuvier
- Breast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Sylvie Giacchetti
- Breast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Luis Teixeira
- Breast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Marc Espié
- Breast Disease Unit, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Cédric de Bazelaire
- Department of Radiology, Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France
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11
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de Margerie-Mellon C, Gill RR, Monteiro Filho AC, Heidinger BH, Onken A, VanderLaan PA, Bankier AA. Growth Assessment of Pulmonary Adenocarcinomas Manifesting as Subsolid Nodules on CT: Comparison of Diameter-Based and Volume Measurements. Acad Radiol 2020; 27:1385-1393. [PMID: 31732419 DOI: 10.1016/j.acra.2019.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 12/18/2022]
Abstract
RATIONALE AND OBJECTIVES To analyze the performances of diameter-based measurements, either using diameters, or by calculating diameter-based volumes, as compared to volume measurements in assessing growth of pulmonary adenocarcinomas manifesting as subsolid nodules on CT. MATERIALS AND METHODS In this IRB-approved, retrospective study, 74 pulmonary adenocarcinomas presenting as subsolid nodules and resected in 69 patients (21 men, 48 women, mean age 70 ± 9 years) were included. Three CTs were available for each patient. Nodule size on each CT was assessed with diameter measurements, calculated volume based on diameter measurements, and measured volume. Nodule growth was defined as an increase of measured volume ≥25% between two sequential CTs. Sensitivity, specificity, accuracy, positive and negative predictive values of diameter-based measurements for growth assessment were calculated. Nodule characteristics were compared with nonparametric tests and analysis of variance. RESULTS There were fewer growing nodules during CT1-CT2 interval (n = 22, 30%) than during CT2-CT3 interval (n = 33, 45%, p =.060). Specificity and negative predictive value of diameter-based measurements for growth assessment ranged respectively from 52 to 77% and 81 to 83% between CT1 and CT2, and from 66 to 76% and 79 to 90% between CT2 and CT3. Nongrowing nodules tended to be larger, regardless how size was measured, and some of these differences in size were statistically significant (p =.002 to .046). CONCLUSION For pulmonary adenocarcinomas presenting as subsolid nodules on CT, diameter-based assessment of nodule volume is reasonably accurate at confirming a lack of nodule growth but may overestimate actual growth, as compared to growth assessment based on measured volume.
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de Margerie-Mellon C, Gill RR, Salazar P, Oikonomou A, Nguyen ET, Heidinger BH, Medina MA, VanderLaan PA, Bankier AA. Assessing invasiveness of subsolid lung adenocarcinomas with combined attenuation and geometric feature models. Sci Rep 2020; 10:14585. [PMID: 32883973 PMCID: PMC7471897 DOI: 10.1038/s41598-020-70316-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/13/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of this study was to develop and test multiclass predictive models for assessing the invasiveness of individual lung adenocarcinomas presenting as subsolid nodules on computed tomography (CT). 227 lung adenocarcinomas were included: 31 atypical adenomatous hyperplasia and adenocarcinomas in situ (class H1), 64 minimally invasive adenocarcinomas (class H2) and 132 invasive adenocarcinomas (class H3). Nodules were segmented, and geometric and CT attenuation features including functional principal component analysis features (FPC1 and FPC2) were extracted. After a feature selection step, two predictive models were built with ordinal regression: Model 1 based on volume (log) (logarithm of the nodule volume) and FPC1, and Model 2 based on volume (log) and Q.875 (CT attenuation value at the 87.5% percentile). Using the 200-repeats Monte-Carlo cross-validation method, these models provided a multiclass classification of invasiveness with discriminative power AUCs of 0.83 to 0.87 and predicted the class probabilities with less than a 10% average error. The predictive modelling approach adopted in this paper provides a detailed insight on how the value of the main predictors contribute to the probability of nodule invasiveness and underlines the role of nodule CT attenuation features in the nodule invasiveness classification.
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Affiliation(s)
| | - Ritu R Gill
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Anastasia Oikonomou
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Elsie T Nguyen
- Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, Canada
| | - Benedikt H Heidinger
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Biomedical Imaging and Image-Guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Mayra A Medina
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Paul A VanderLaan
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Alexander A Bankier
- Department of Radiology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
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de Margerie-Mellon C, Ngo LH, Gill RR, Monteiro Filho AC, Heidinger BH, Onken A, Medina MA, VanderLaan PA, Bankier AA. The Growth Rate of Subsolid Lung Adenocarcinoma Nodules at Chest CT. Radiology 2020; 297:189-198. [PMID: 32749206 DOI: 10.1148/radiol.2020192322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Confirming that subsolid adenocarcinomas show exponential growth is important because it would justify using volume doubling time to assess their growth. Purpose To test whether the growth of lung adenocarcinomas manifesting as subsolid nodules at chest CT is accurately represented by an exponential model. Materials and Methods Patients with lung adenocarcinomas manifesting as subsolid nodules surgically resected between January 2005 and May 2018, with three or more longitudinal CT examinations before resection, were retrospectively included. Overall volume (for all nodules) and solid component volume (for part-solid nodules) were measured over time. A linear mixed-effects model was used to identify the growth pattern (linear, exponential, quadratic, or power law) that best represented growth. The interactions between nodule growth and clinical, CT morphologic, and pathologic parameters were studied. Results Sixty-nine patients (mean age, 70 years ± 9 [standard deviation]; 48 women) with 74 lung adenocarcinomas were evaluated. Overall growth and solid component growth were better represented by an exponential model (adjusted R2 = 0.89 and 0.95, respectively) than by a quadratic model (r2 = 0.88 and 0.93, respectively), a linear model (r2 = 0.87 and 0.92, respectively), or a power law model (r2 = 0.82 and 0.93, respectively). Faster overall volume growth was associated with a history of lung cancer (P < .001), a baseline nodule volume less than 500 mm3 (P = .03), and histologic findings of invasive adenocarcinoma (P < .001). The median volume doubling time of noninvasive adenocarcinoma was significantly longer than that of invasive adenocarcinoma (939 days [interquartile range, 588-1563 days] vs 678 days [interquartile range, 392-916 days], respectively; P = .01). Conclusion The overall volume growth of adenocarcinomas manifesting as subsolid nodules at chest CT was best represented by an exponential model compared with the other tested models. This justifies the use of volume doubling time for the growth assessment of these nodules. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Kuriyama and Yanagawa in this issue.
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Affiliation(s)
- Constance de Margerie-Mellon
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Long H Ngo
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Ritu R Gill
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Antonio C Monteiro Filho
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Benedikt H Heidinger
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Allison Onken
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Mayra A Medina
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Paul A VanderLaan
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
| | - Alexander A Bankier
- From the Departments of Radiology (C.d.M.M., R.R.G., A.C.M.F., B.H.H., A.A.B.), General Medicine (L.H.N.), and Pathology (A.O., M.A.M., P.A.V.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (L.H.N.); and Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria (B.H.H.)
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de Margerie-Mellon C, VanderLaan PA, Heidinger BH, Bankier AA. Role of imaging in predicting tumor spread through airspaces (STAS): what are the next steps. J Thorac Dis 2020; 12:1154-1156. [PMID: 32274193 PMCID: PMC7138983 DOI: 10.21037/jtd.2019.11.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Paul A VanderLaan
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Benedikt H Heidinger
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.,Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Alexander A Bankier
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Medina MA, Onken AM, de Margerie-Mellon C, Heidinger BH, Chen Y, Bankier AA, VanderLaan PA. Preoperative bronchial cytology for the assessment of tumor spread through air spaces in lung adenocarcinoma resection specimens. Cancer Cytopathol 2020; 128:278-286. [PMID: 32012490 DOI: 10.1002/cncy.22243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Tumor spread through air spaces (STAS), a significant prognostic indicator, has been described recently as a pattern of invasion in pulmonary carcinomas. However, questions remain regarding preoperative identification of STAS and whether it represents an in vivo phenomenon versus an ex vivo artifact. METHODS We retrospectively reviewed 67 paired preoperative bronchoalveolar lavage (BAL) or bronchial washing (BW) cytology specimens with the subsequent lung adenocarcinoma surgical resection specimen to determine whether preoperative cytology could predict STAS. Other clinical, radiologic, and pathologic features of the resected lesions were also correlated with preoperative bronchial cytology results. RESULTS Positive bronchial cytology was observed in 28 cases (41.8%), 24 of which had STAS (85.7%); however, negative BAL/BW cytology was observed in 39 cases (58.2%), 29 of which had STAS (74.4%) (x2 = 1.27, P = .26, not significant). High-STAS burden was observed in 44 cases (83.0%), 21 (47.7%) with negative BAL/BW and 23 (52.3%) with positive BAL/BW. Low-STAS burden was observed in 9 cases (17.0%), 8 (88.9%) with negative BAL/BW and only 1 (11.1%) with positive BAL/BW (x2 = 5.11, P = .024, significant). For tumors with STAS, a statistically significant difference was identified in the maximal STAS distance from the main tumor edge between BAL/BW-positive and BAL/BW-negative groups (P = .007). Of the remaining clinicopathologic and radiologic features, only visceral pleural invasion was significantly associated with BAL/BW positivity. CONCLUSION Presurgical bronchial cytology alone cannot adequately predict tumor STAS; however, it may provide useful information regarding the extent and overall burden of STAS on the subsequent resection specimen.
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Affiliation(s)
- Mayra A Medina
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Allison M Onken
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | | | - Benedikt H Heidinger
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Yigu Chen
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Alexander A Bankier
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Paul A VanderLaan
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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Heidinger BH, Silva M, de Margerie-Mellon C, VanderLaan PA, Bankier AA. The natural course of incidentally detected, small, subsolid lung nodules-is follow-up needed beyond current guideline recommendations? Transl Lung Cancer Res 2019; 8:S412-S417. [PMID: 32038927 DOI: 10.21037/tlcr.2019.11.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Benedikt H Heidinger
- Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Mario Silva
- Section of Radiology, Unit of Surgical Sciences, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.,Department of Thoracic Surgery, IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Paul A VanderLaan
- Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alexander A Bankier
- Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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de Margerie-Mellon C, Bankier AA. To Be or Not to Be … a Pulmonary Nodule. Radiol Cardiothorac Imaging 2019; 1:e190201. [PMID: 33778533 PMCID: PMC7977753 DOI: 10.1148/ryct.2019190201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 10/14/2019] [Indexed: 06/12/2023]
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de Margerie-Mellon C, Belin L, Boussouar S, Khafagy P, Debray MP, Levand K, Chabi ML, Khalil A, Benattia A, Israël-Biet D, Crestani B, Nunes H, Cadranel J, Grenier P, Valeyre D, Naccache JM, Brillet PY. Computed tomography assessment of peripheral traction bronchiolectasis: impact of minimal intensity projection. Eur Respir J 2019; 55:13993003.01388-2019. [PMID: 31649065 DOI: 10.1183/13993003.01388-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 10/04/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Constance de Margerie-Mellon
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Service de Radiologie, Paris, France
| | - Lisa Belin
- Sorbonne Université, INSERM UMR 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpétrière-Charles Foix, Département Biostatistique, Santé Publique et Information Médicale, Paris, France
| | - Samia Boussouar
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpétrière-Charles Foix, Service de Radiologie, Paris, France
| | | | - Marie-Pierre Debray
- Université de Paris, INSERM UMR 1152 "Physiopathologie et épidémiologie des maladies respiratoires", Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Radiologie, Paris, France
| | - Kim Levand
- Université Paris 13, INSERM UMR 1272 "Hypoxie et Poumon", Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Radiologie, Bobigny, France
| | | | - Antoine Khalil
- Université de Paris, INSERM UMR 1152 "Physiopathologie et épidémiologie des maladies respiratoires", Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Radiologie, Paris, France
| | - Amira Benattia
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Pneumologie, Paris, France
| | - Dominique Israël-Biet
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Pneumologie, Paris, France
| | - Bruno Crestani
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Service de Pneumologie, Paris, France
| | - Hilario Nunes
- Université Paris 13, INSERM UMR 1272 "Hypoxie et Poumon", Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France
| | - Jacques Cadranel
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de pneumologie et Centre Constitutif des Maladies Pulmonaires Rares, Paris, France
| | - Philippe Grenier
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpétrière-Charles Foix, Service de Radiologie, Paris, France
| | - Dominique Valeyre
- Université Paris 13, INSERM UMR 1272 "Hypoxie et Poumon", Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Pneumologie, Bobigny, France
| | - Jean-Marc Naccache
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de pneumologie et Centre Constitutif des Maladies Pulmonaires Rares, Paris, France
| | - Pierre-Yves Brillet
- Université Paris 13, INSERM UMR 1272 "Hypoxie et Poumon", Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Radiologie, Bobigny, France
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Le Guen P, Chevret S, Bugnet E, de Margerie-Mellon C, Lorillon G, Seguin-Givelet A, Jouenne F, Gossot D, Vassallo R, Tazi A. Management and outcomes of pneumothorax in adult patients with Langerhans cell Histiocytosis. Orphanet J Rare Dis 2019; 14:229. [PMID: 31639032 PMCID: PMC6805357 DOI: 10.1186/s13023-019-1203-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/13/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Pneumothorax may recur during pulmonary Langerhans cell histiocytosis (PLCH) patients' follow-up and its management is not standardised. The factors associated with pneumothorax recurrence are unknown. METHODS In this retrospective study, PLCH patients who experienced a pneumothorax and were followed for at least 6 months after the first episode were eligible. The objectives were to describe the treatment of the initial episode and pneumothorax recurrences during follow-up. We also searched for factors associated with pneumothorax recurrence and evaluated the effect on lung function outcome. Time to recurrence was estimated by the Kaplan Meier method and the cumulative hazard of recurrence handling all recurrent events was estimated. Univariate Cox models and Andersen-Gill counting process were used for statistical analyses. RESULTS Fourty-three patients (median age 26.5 years [interquartile range (IQR), 22.9-35.4]; 26 men, 39 current smokers) were included and followed for median time of 49 months. Chest tube drainage was the main management of the initial pneumothorax, which resolved in 70% of cases. Pneumothorax recurred in 23 (53%) patients, and overall 96 pneumothoraces were observed during the study period. In the subgroup of patients who experienced pneumothorax recurrence, the median number of episodes per patient was 3 [IQR, 2-4]. All but one recurrence occurred within 2 years after the first episode. Thoracic surgery neither delayed the time of occurrence of the first ipsilateral recurrence nor reduced the overall number of recurrences during the study period, although the rate of recurrence was lower after thoracotomy than following video-assisted thoracic surgery (p = 0.03). At the time of the first pneumothorax, the presence of air trapping on lung function testing was associated with increased risk of recurrence (hazard ratio = 5.08; 95% confidence interval [1.18, 21.8]; p = 0.03). Pneumothorax recurrence did not predict subsequent lung function decline (p = 0.058). CONCLUSIONS Our results show that pneumothorax recurrences occur during an "active" phase of PLCH. In this observational study, the time of occurrence of the first ipsilateral recurrence and the overall number of pneumothorax recurrences were similar after conservative and thoracic surgical treatments. Further studies are needed to determine the best management to reduce the risk of pneumothorax recurrence in PLCH patients.
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Affiliation(s)
- Pierre Le Guen
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Centre National de Référence des Histiocytoses, Service de Pneumologie, 1 Avenue Claude Vellefaux, 75475, Paris, Cedex 10, France
| | - Sylvie Chevret
- Université de Paris, U1153 CRESS, Equipe de Recherche en Biostatistiques et Epidémiologie Clinique (ECSTRRA), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Service de Biostatistique et Information Médicale, Paris, France
| | - Emmanuelle Bugnet
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Centre National de Référence des Histiocytoses, Service de Pneumologie, 1 Avenue Claude Vellefaux, 75475, Paris, Cedex 10, France
| | - Constance de Margerie-Mellon
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Service de Radiologie, Paris, France
| | - Gwenaël Lorillon
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Centre National de Référence des Histiocytoses, Service de Pneumologie, 1 Avenue Claude Vellefaux, 75475, Paris, Cedex 10, France
| | - Agathe Seguin-Givelet
- Département Thoracique, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France
| | - Fanélie Jouenne
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Laboratoire de Pharmacologie Biologique, Paris, France
| | - Dominique Gossot
- Département Thoracique, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France
| | - Robert Vassallo
- Departments of Medicine, Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Abdellatif Tazi
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Centre National de Référence des Histiocytoses, Service de Pneumologie, 1 Avenue Claude Vellefaux, 75475, Paris, Cedex 10, France. .,Université de Paris, U1153 CRESS, Equipe de Recherche en Biostatistiques et Epidémiologie Clinique (ECSTRRA), Paris, France.
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Heidinger BH, Schwarz-Nemec U, Anderson KR, de Margerie-Mellon C, Monteiro Filho AC, Chen Y, Mayerhoefer ME, VanderLaan PA, Bankier AA. Visceral Pleural Invasion in Pulmonary Adenocarcinoma: Differences in CT Patterns between Solid and Subsolid Cancers. Radiol Cardiothorac Imaging 2019; 1:e190071. [PMID: 33778512 PMCID: PMC7977962 DOI: 10.1148/ryct.2019190071] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/20/2019] [Accepted: 06/25/2019] [Indexed: 04/12/2023]
Abstract
PURPOSE To analyze the incidence and CT patterns of visceral pleural invasion (VPI) in adenocarcinomas on the basis of their CT presentation as solid or subsolid nodules. MATERIALS AND METHODS A total of 286 adenocarcinomas in direct contact with a pleural surface, resected at an institution between 2005 and 2016, were included in this retrospective, institutional review board-approved study. CT size and longest contact length with a pleural surface were measured and their ratios computed. Pleural deviation, pleural thickening, spiculations, different pleural tag types, pleural effusion, and the CT appearance of transgression into an adjacent lobe or infiltration of surrounding tissue were evaluated. Fisher exact tests and simple and multiple logistic regression models were used. RESULTS Of the 286 nodules, 179 of 286 (62.6%) were solid and 107 of 286 (37.4%) were subsolid. VPI was present in 49 of 286 (17.1%) nodules and was significantly more frequent in solid (44 of 179; 24.6%) than in subsolid nodules (five of 107; 4.7%; P < .001). In solid nodules, multiple regression analysis showed an association of higher contact length-to-size ratio (adjusted odds ratio [OR], 1.02; P = .007) and the presence of multiple pleural tag types (adjusted OR, 5.88; P = .002) with VPI. In subsolid nodules, longer pleural contact length of the solid nodular component (adjusted OR, 1.27; P = .017) and the CT appearance of transgression or infiltration (adjusted OR, 10.75; P = .037) were associated with VPI. CONCLUSION During preoperative evaluation of adenocarcinomas for the likelihood of VPI, whether a tumor manifests as a solid or a subsolid nodule is important to consider because the incidence of VPI is significantly higher in solid than in subsolid nodules. In addition, this study showed that the CT patterns associated with VPI differ between solid and subsolid nodules.© RSNA, 2019Supplemental material is available for this article.See also the commentary by Elicker in this issue.
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21
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de Margerie-Mellon C, VanderLaan PA, Bankier AA. CT Manifestations of Tumor Spread through Air Spaces in Lung Adenocarcinoma: Different Pathways toward Common Perspectives. Radiology 2019; 290:271-272. [DOI: 10.1148/radiol.2018182173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Paul A. VanderLaan
- Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215
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Xhaard A, Porcher R, Bergeron A, Alanio A, Touratier S, Bretagne S, de Margerie-Mellon C, Sicre de Fontbrune F, Itzykson R, Coman T, Robin M, Cabannes-Hamy A, Socié G, Peffault de Latour R. Primary antifungal prophylaxis with micafungin after allogeneic hematopoietic stem cell transplantation: a monocentric prospective study. Ann Hematol 2018; 98:1033-1035. [DOI: 10.1007/s00277-018-3530-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022]
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23
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Lorillon G, Jouenne F, Baroudjian B, de Margerie-Mellon C, Vercellino L, Meignin V, Lebbe C, Vassallo R, Mourah S, Tazi A. Response to Trametinib of a Pulmonary Langerhans Cell Histiocytosis Harboring a MAP2K1 Deletion. Am J Respir Crit Care Med 2018; 198:675-678. [DOI: 10.1164/rccm.201802-0275le] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
| | - Fanelie Jouenne
- Assistance Publique-Hôpitaux de ParisParis, France
- Université Paris DiderotParis, France
| | | | | | | | - Véronique Meignin
- Assistance Publique-Hôpitaux de ParisParis, France
- INSERM UMR_S1165Paris, France
| | - Celeste Lebbe
- Assistance Publique-Hôpitaux de ParisParis, France
- Université Paris DiderotParis, France
- INSERM U976Paris, France
| | | | - Samia Mourah
- Assistance Publique-Hôpitaux de ParisParis, France
- Université Paris DiderotParis, France
- INSERM U976Paris, France
| | - Abdellatif Tazi
- Assistance Publique-Hôpitaux de ParisParis, France
- Université Paris DiderotParis, France
- U1153 CRESSParis, France
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Bergeron A, Chevret S, Peffault de Latour R, Chagnon K, de Margerie-Mellon C, Rivière F, Robin M, Mani J, Lorillon G, Socié G, Tazi A. Noninfectious lung complications after allogeneic haematopoietic stem cell transplantation. Eur Respir J 2018; 51:13993003.02617-2017. [PMID: 29650555 DOI: 10.1183/13993003.02617-2017] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 03/14/2018] [Indexed: 12/13/2022]
Abstract
Epidemiological data on late-onset noninfectious pulmonary complications (LONIPCs) following allogeneic haematopoietic stem cell transplantation (HSCT) are derived exclusively from retrospective studies and are conflicting. We aimed to evaluate prospectively the incidence, risk factors and outcomes for LONIPCs.All consecutive patients scheduled to receive allogeneic HSCT between 2006 and 2008 at a university teaching hospital in France were screened for inclusion in the study. Eligible patients were those surviving at day 100. Among 243 screened patients, 198 patients were included in the analysis. The median (interquartile range) follow-up was 72.3 (15.2-88.5) months. 55 LONIPCs were diagnosed in 43 patients. Bronchiolitis obliterans syndrome (n=22) and interstitial lung disease (n=12) were the most common LONIPCs. At 36 months after inclusion, the estimated cumulative incidence of LONIPCs was 19.8% (95% CI 14.2-25.3%). The estimated median survival after the diagnosis of LONIPCs was 78.5 months (95% CI 20.0-not reached). Based on a multivariate Cox model, a history of chest irradiation anytime prior to HSCT, a history of pneumonia within 100 days post-HSCT and a low mean forced expiratory flow at 25-75% of forced vital capacity at day 100 were associated with the development of LONIPCs.Our data provide clues to identify patients at high risk of developing LONIPCs. These patients should be targeted for close monitoring to provide earlier LONIPC treatment or prophylactic treatment.
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Affiliation(s)
- Anne Bergeron
- AP-HP, Hôpital Saint-Louis, Service de Pneumologie, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR 1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France
| | - Sylvie Chevret
- Université Paris Diderot, Sorbonne Paris Cité, UMR 1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France.,AP-HP, Hôpital Saint-Louis, Service de Biostatistique et Information Médicale, Paris, France
| | - Régis Peffault de Latour
- Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France
| | - Karine Chagnon
- AP-HP, Hôpital Saint-Louis, Service de Pneumologie, Paris, France.,Université de Montréal, Service de Pneumologie, Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
| | | | - Frédéric Rivière
- AP-HP, Hôpital Saint-Louis, Service de Pneumologie, Paris, France
| | - Marie Robin
- Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France
| | - Jean Mani
- Département d'Imagerie Clinique du Sport, Paris, France
| | - Gwenael Lorillon
- AP-HP, Hôpital Saint-Louis, Service de Pneumologie, Paris, France
| | - Gérard Socié
- Université Paris Diderot, Sorbonne Paris Cité, AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France.,These two authors contributed equally to this work
| | - Abdellatif Tazi
- AP-HP, Hôpital Saint-Louis, Service de Pneumologie, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR 1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France.,These two authors contributed equally to this work
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de Margerie-Mellon C, Heidinger BH, Bankier AA. 2D or 3D measurements of pulmonary nodules: preliminary answers and more open questions. J Thorac Dis 2018; 10:547-549. [PMID: 29608182 DOI: 10.21037/jtd.2018.01.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | - Benedikt H Heidinger
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Alexander A Bankier
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Morin S, Grateau A, Reuter D, de Kerviler E, de Margerie-Mellon C, de Bazelaire C, Zafrani L, Schlemmer B, Azoulay E, Canet E. Management of superior vena cava syndrome in critically ill cancer patients. Support Care Cancer 2017; 26:521-528. [PMID: 28836006 DOI: 10.1007/s00520-017-3860-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 08/16/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this study is to describe the management and outcome of critically ill cancer patients with Superior Vena Cava Syndrome (SVCS). METHODS All cancer patients admitted to the medical intensive care unit (ICU) of the Saint-Louis University Hospital for a SVCS between January 2004 and December 2016 were included. RESULTS Of the 50 patients included in the study, obstruction of the superior vena cava was partial in two-thirds of the cases and complete in one-third. Pleural effusion was reported in two-thirds of the patients, pulmonary atelectasis in 16 (32%), and pulmonary embolism in five (10%). Computed tomography of the chest showed upper airway compression in 18 (36%) cases, while echocardiography revealed 22 (44%) pericardial effusions. The causes of SVCS were diagnosed one (0-3) day after ICU admission, using interventional radiology procedures in 70% of the cases. Thirty (60%) patients had hematological malignancies, and 20 (40%) had solid tumors. Fifteen (30%) patients required invasive mechanical ventilation, seven (14%) received vasopressors, and renal replacement therapy was implemented in three (6%). ICU, in-hospital, and 6-month mortality rates were 20, 26, and 48%, respectively. The cause of SVCS was the only factor independently associated with day 180 mortality by multivariate analysis. Patients with hematological malignancies had a lower mortality than those with solid tumors (27 versus 80%) (odds ratio 0.12, 95% confidence interval (0.02-0.60), p < 0.01). CONCLUSION Airway obstruction and pleural and pericardial effusions contributed to the unstable condition of cancer patients with SVCS. The vital prognosis of SVCS was mainly related to the underlying diagnosis.
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Affiliation(s)
- Sarah Morin
- Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France
| | - Adeline Grateau
- Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France
| | - Danielle Reuter
- Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France
| | - Eric de Kerviler
- Department of Radiology, Saint-Louis University Hospital, AP-HP, Paris, France.,Paris Diderot University-Sorbonne Paris Cité, Paris, France
| | | | - Cédric de Bazelaire
- Department of Radiology, Saint-Louis University Hospital, AP-HP, Paris, France.,Paris Diderot University-Sorbonne Paris Cité, Paris, France
| | - Lara Zafrani
- Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France.,Paris Diderot University-Sorbonne Paris Cité, Paris, France
| | - Benoit Schlemmer
- Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France.,Paris Diderot University-Sorbonne Paris Cité, Paris, France
| | - Elie Azoulay
- Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France.,Paris Diderot University-Sorbonne Paris Cité, Paris, France
| | - Emmanuel Canet
- Medical Intensive Care Unit, Saint-Louis University Hospital, AP-HP, 1 avenue Claude Vellefaux, 75010, Paris, France.
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de Margerie-Mellon C, de Bazelaire C, Montlahuc C, Lambert J, Martineau A, Coulon P, de Kerviler E, Beigelman C. Reducing Radiation Dose at Chest CT: Comparison Among Model-based Type Iterative Reconstruction, Hybrid Iterative Reconstruction, and Filtered Back Projection. Acad Radiol 2016; 23:1246-54. [PMID: 27346234 DOI: 10.1016/j.acra.2016.05.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 12/15/2022]
Abstract
RATIONALE AND OBJECTIVES The study aimed to evaluate the performances of two iterative reconstruction (IR) algorithms and of filtered back projection (FBP) when using reduced-dose chest computed tomography (RDCT) compared to standard-of-care CT. MATERIALS AND METHODS An institutional review board approval was obtained. Thirty-six patients with hematologic malignancies referred for a control chest CT of a known lung disease were prospectively enrolled. Patients underwent standard-of-care scan reconstructed with hybrid IR, followed by an RDCT reconstructed with FBP, hybrid IR, and iterative model reconstruction. Objective and subjective quality measurements, lesion detectability, and evolution assessment on RDCT were recorded. RESULTS For RDCT, the CTDIvol (volumetric computed tomography dose index) was 0.43 mGy⋅cm for all patients, and the median [interquartile range] effective dose was 0.22 mSv [0.22-0.24]; corresponding measurements for standard-of-care scan were 3.4 mGy [3.1-3.9] and 1.8 mSv [1.6-2.0]. Noise significantly decreased from FBP to hybrid IR and from hybrid IR to iterative model reconstruction on RDCT, whereas lesion conspicuity and diagnostic confidence increased. Accurate evolution assessment was obtained in all cases with IR. Emphysema identification was higher with iterative model reconstruction. CONCLUSION Although iterative model reconstruction offered better diagnostic confidence and emphysema detection, both IR algorithms allowed an accurate evolution assessment with an effective dose of 0.22 mSv.
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Cornetto MA, Chevret S, Abbes S, de Margerie-Mellon C, Hussenet C, Sicre de Fontbrune F, Tazi A, Ribaud P, Bergeron A. Early Lung Computed Tomography Scan after Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2016; 22:1511-1516. [PMID: 27189110 DOI: 10.1016/j.bbmt.2016.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/09/2016] [Indexed: 11/24/2022]
Abstract
A lung computed tomography (CT) scan is essential for diagnosing lung diseases in hematopoietic stem cell transplantation (HSCT) recipients. As a result, lung CT scans are increasingly prescribed in the early phase after allogeneic HSCT, with no assessment of the added value for global patient management. Among 250 patients who underwent allogeneic HSCT in our center over a 2-year period, we evaluated 68 patients who had at least 1 lung CT scan within the first 30 days post-transplantation. The median interval between allogeneic HSCT and lung CT scan was 8.5 days. Patients who underwent an early lung CT scan were more immunocompromised and had a more severe course. Fever was the main indication for the CT scan (78%). The lung CT scan was abnormal in 52 patients, including 17 patients who had an abnormal pre-HSCT CT scan. A therapeutic change was noted in 37 patients (54%) within 24 hours after the lung CT scan. The main changes included the introduction of corticosteroids (n = 23; 62%), especially in patients with a normal CT scan (89%). In univariate models, we found that a normal pretransplantation CT scan (P = .002), the absence of either dyspnea (P = .029) or hypoxemia (P = .015), and a serum C-reactive protein level <10 mg/L (P = .004) were associated with a normal post-HSCT lung CT scan. We found that the association of these variables could predict the normality of early post-HSCT lung CT scans. Pretransplantation lung CT scans are useful for the interpretation of subsequent lung CT scans following allogeneic HSCT, which are frequently abnormal. Early post-HSCT lung CT scans are helpful in patient management, but prescriptions could be more targeted.
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Affiliation(s)
| | - Sylvie Chevret
- Univ Paris Diderot, Sorbonne Paris Cité, UMR1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France; Service de Biostatistique et Information Médicale AP-HP, Hôpital Saint-Louis, Paris, France
| | - Sarah Abbes
- Univ Paris Diderot, Sorbonne Paris Cité; AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France; Service de Pneumologie, CHU Nantes, Nantes, France
| | | | - Claire Hussenet
- Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Flore Sicre de Fontbrune
- Univ Paris Diderot, Sorbonne Paris Cité; AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France
| | - Abdellatif Tazi
- Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France; Univ Paris Diderot, Sorbonne Paris Cité, UMR1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France
| | - Patricia Ribaud
- Univ Paris Diderot, Sorbonne Paris Cité; AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France
| | - Anne Bergeron
- Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France; Univ Paris Diderot, Sorbonne Paris Cité, UMR1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France.
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Tazi A, de Margerie-Mellon C, Vercellino L, Naccache JM, Fry S, Dominique S, Jouneau S, Lorillon G, Bugnet E, Chiron R, Wallaert B, Valeyre D, Chevret S. Extrathoracic investigation in adult patients with isolated pulmonary langerhans cell histiocytosis. Orphanet J Rare Dis 2016; 11:11. [PMID: 26833097 PMCID: PMC4736248 DOI: 10.1186/s13023-016-0387-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 01/13/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND An important objective on diagnosis of patients with Langerhans cell histiocytosis (LCH) is to determine the extent of disease. However, whether systematic extrathoracic investigation is needed in adult patients with clinically isolated pulmonary LCH (PLCH) has not been evaluated. METHODS In this prospective, multicentre study, 54 consecutive patients with newly diagnosed clinically isolated PLCH were systematically evaluated at inclusion by bone imaging and blood laboratory testing to search for subclinical extrapulmonary LCH involvement. The patients were followed over a 2-year period. At each visit, they were asked about the presence of extrapulmonary manifestations of LCH. RESULTS In the absence of bone symptoms, the skeletal X-ray survey results were normal for all but two patients who had a localised bone lesion consistent with possible LCH involvement, that remained unchanged over 2 years of follow-up. Whole-body bone scintigraphy did not add information to the plain radiography findings for the detection of asymptomatic bone involvement in isolated PLCH. Conversely, it showed nonspecific focal bone uptake in 18% of the patients, mainly corresponding to post-traumatic or degenerative abnormalities unrelated to LCH. Mild leucocytosis due to neutrophilia was observed in 22% of the patients and was not related to their smoking habits. Three patients had mild isolated lymphocytosis without haematological disease, whereas two patients had mild lymphopaenia. A mild inflammatory biological syndrome was observed in a minority of patients without infection or constitutional symptoms and was not associated with progressive disease. A substantial proportion (24.5%) of the patients had abnormal biological liver test results, including elevated liver enzymes and/or cholestasis, which were not linked to LCH involvement in this cohort. CONCLUSIONS Obtaining a thorough history and performing comprehensive physical examination are essential for staging patients diagnosed with PLCH. In the absence of symptoms or signs suggestive of extrapulmonary LCH involvement, the systematic performing of recommended bone imaging does not appear informative. Although the observed blood laboratory abnormalities were not specifically related to LCH, performing these tests in the diagnostic workup for PLCH is useful because some of these alterations may impact patient management. TRIAL REGISTRATION ClinicalTrials.gov: No. NCT01225601; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Abdellatif Tazi
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Centre National de Référence de l'histiocytose Langerhansienne, Service de Pneumologie, 1 Avenue Claude Vellefaux, 75475 cedex 10, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, U1153 CRESS, Biostatistics and Clinical Epidemiology research team, Paris, France.
| | | | - Laetitia Vercellino
- Assistance Publique-Hôpitaux de Paris, Service de Médecine Nucléaire, Hôpital Saint-Louis, Paris, France
| | - Jean Marc Naccache
- Assistance Publique-Hôpitaux de Paris, Service de Pneumologie, Hôpital Avicenne, Bobigny, France
| | - Stéphanie Fry
- Service de Pneumologie et Immuno-allergologie, Centre de compétence des maladies pulmonaires rares, Hôpital Calmette, Lille, France
| | | | - Stéphane Jouneau
- IRSET UMR 1085, Université de Rennes 1; Service de Pneumologie, Hôpital Pontchaillou, Rennes, France
| | - Gwenaël Lorillon
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Centre National de Référence de l'histiocytose Langerhansienne, Service de Pneumologie, 1 Avenue Claude Vellefaux, 75475 cedex 10, Paris, France
| | - Emmanuelle Bugnet
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Centre National de Référence de l'histiocytose Langerhansienne, Service de Pneumologie, 1 Avenue Claude Vellefaux, 75475 cedex 10, Paris, France
| | - Raphael Chiron
- Département de Pneumologie, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - Benoit Wallaert
- Service de Pneumologie et Immuno-allergologie, Centre de compétence des maladies pulmonaires rares, Hôpital Calmette, Lille, France.,Université Lille 2, Lille, France
| | - Dominique Valeyre
- Université Paris 13, Sorbonne Paris Cité; Assistance Publique-Hôpitaux de Paris, Service de Pneumologie, Hôpital Avicenne, Bobigny, France
| | - Sylvie Chevret
- Université Paris Diderot, Sorbonne Paris Cité, U1153 CRESS, Biostatistics and Clinical Epidemiology research team, Paris, France.,Assistance Publique-Hôpitaux de Paris; Hôpital Saint-Louis, Service de Biostatistique et Information Médicale, Paris, France
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de Margerie-Mellon C, Kaci R, Laredo JD, Bousson V. Multiple small sclerotic bone lesions revealing invasive lobular breast carcinoma. Joint Bone Spine 2014; 82:129-30. [PMID: 25241338 DOI: 10.1016/j.jbspin.2014.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 08/05/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Constance de Margerie-Mellon
- Department of Osteoarticular Radiology, Université Paris Diderot, hôpital Lariboisière, 2, rue Ambroise-Paré, Sorbonne Paris Cité, 75475 Paris cedex 10, France.
| | - Rachid Kaci
- Department of Pathology, université Paris Diderot, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, Sorbonne Paris Cité, 75475 Paris cedex 10, France
| | - Jean-Denis Laredo
- Department of Osteoarticular Radiology, Université Paris Diderot, hôpital Lariboisière, 2, rue Ambroise-Paré, Sorbonne Paris Cité, 75475 Paris cedex 10, France
| | - Valérie Bousson
- Department of Osteoarticular Radiology, Université Paris Diderot, hôpital Lariboisière, 2, rue Ambroise-Paré, Sorbonne Paris Cité, 75475 Paris cedex 10, France
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de Margerie-Mellon C, Turc G, Tisserand M, Naggara O, Calvet D, Legrand L, Meder JF, Mas JL, Baron JC, Oppenheim C. Can DWI-ASPECTS Substitute for Lesion Volume in Acute Stroke? Stroke 2013; 44:3565-7. [PMID: 24092549 DOI: 10.1161/strokeaha.113.003047] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
The extent of diffusion lesion on pretreatment imaging is a risk factor for poor outcome and hemorrhagic transformation after thrombolysis, and volumes of 70 to 100 mL have been advocated as cut-offs. However, estimating diffusion-weighted imaging (DWI) lesion volume (Vol
DWI
) in the acute setting may be cumbersome. We aimed to determine whether the DWI-Alberta Stroke Program Early CT Score (DWI-ASPECTS) can substitute for Vol
DWI
.
Methods—
DWI-ASPECTS and Vol
DWI
were measured retrospectively on pretreatment MRI (median onset-to-MRI delay=122 minutes) in 330 consecutively treated patients with middle cerebral artery stroke.
Results—
DWI-ASPECTS and Vol
DWI
were strongly correlated (ρ=−0.82), but each DWI-ASPECTS point corresponded to a wide range of Vol
DWI
. All patients with DWI-ASPECTS ≥7 (n=207) had Vol
DWI
<70 mL, whereas 32 of the 34 patients with DWI-ASPECTS <4 had Vol
DWI
>100 mL. However, intermediate DWI-ASPECTS (4–6; n=89) corresponded to highly variable Vol
DWI
(median, 66 mL; interquartile range, 40–98).
Conclusions—
Although each DWI-ASPECTS point corresponds to a wide range of volumes, DWI-ASPECTS <4 or ≥7 may be used as reliable surrogates of Vol
DWI
>100 or <70 mL, respectively.
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Affiliation(s)
- Constance de Margerie-Mellon
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Guillaume Turc
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Marie Tisserand
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Olivier Naggara
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - David Calvet
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Laurence Legrand
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Jean-François Meder
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Jean-Louis Mas
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Jean-Claude Baron
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Catherine Oppenheim
- From the Departments of Radiology (C.d.M.-M., M.T., O.N., L.L., J.-F.M., C.O.) and Neurology (G.T., D.C., J.-L.M., J.-C.B.), Centre de Psychiatrie et Neurosciences, INSERM S894, Centre Hospitalier Sainte-Anne, Université Paris Descartes Sorbonne Paris Cité, Paris, France
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