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Conroy T, Pfeiffer P, Vilgrain V, Lamarca A, Seufferlein T, O'Reilly EM, Hackert T, Golan T, Prager G, Haustermans K, Vogel A, Ducreux M. Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2023; 34:987-1002. [PMID: 37678671 DOI: 10.1016/j.annonc.2023.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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: 05/19/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- T Conroy
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy; APEMAC, équipe MICS, Université de Lorraine, Nancy, France
| | - P Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - V Vilgrain
- Centre de Recherche sur l'Inflammation U 1149, Université Paris Cité, Paris; Department of Radiology, Beaujon Hospital, APHP Nord, Clichy, France
| | - A Lamarca
- Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - T Seufferlein
- Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany
| | - E M O'Reilly
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - T Hackert
- Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - T Golan
- Gastrointestinal Unit, Oncology Institute, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - G Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - K Haustermans
- Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
| | - A Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - M Ducreux
- Université Paris-Saclay, Gustave Roussy, Inserm Unité Dynamique des Cellules Tumorales, Villejuif, France
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Vilgrain V. Techniques interventionnelles de modulation hépatique. Bulletin de l'Académie Nationale de Médecine 2022. [DOI: 10.1016/j.banm.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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3
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Reizine E, Ronot M, Ghosn M, Calderaro J, Frulio N, Bioulac-Sage P, Trillaud H, Vilgrain V, Paradis V, Luciani A. Hepatospecific MR contrast agent uptake on hepatobiliary phase can be used as a biomarker of marked β-catenin activation in hepatocellular adenoma. Eur Radiol 2020; 31:3417-3426. [PMID: 33146794 DOI: 10.1007/s00330-020-07434-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/23/2020] [Revised: 09/01/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To assess the value of hepatospecific MR contrast agent uptake on hepatobiliary phase (HBP) images to detect marked activation of the β-catenin pathway in hepatocellular adenomas (HCAs). METHODS This multicentric retrospective IRB-approved study included all patients with a pathologically proven HCA who underwent gadobenate dimeglumine-enhanced liver MRI with HBP. Tumor signal intensity on HBP was first assessed visually, and lesions were classified into three distinct groups-hypointense, isointense, or hyperintense-according to the relative signal intensity to liver. Uptake was then quantified using the lesion-to-liver contrast enhancement ratio (LLCER). Finally, the accuracy of HBP analysis in depicting marked β-catenin activation in HCA was evaluated. RESULTS A total of 124 HCAs were analyzed including 12 with marked β-catenin activation (HCA B+). Visual analysis classified 94/124 (76%), 12/124 (10%), and 18/124 (14%) HCAs as being hypointense, isointense, and hyperintense on HBP, respectively. Of these, 1/94 (1%), 3/12 (25%), and 8/18 (44%) were HCA B+, respectively (p < 0.001). The LLCER of HCA B+ was higher than that of HCA without marked β-catenin activation in the entire cohort (means 4.9 ± 11.8% vs. - 19.8 ± 11.4%, respectively, p < 0.001). A positive LLCER, i.e., LLCER ≥ 0%, had 75% (95% CI 43-95%) sensitivity and 97% (95% CI 92-99%) specificity, with a LR+ of 28 (95% CI 8.8-89.6) for the diagnosis of HCA B+. CONCLUSIONS Hepatospecific contrast uptake on hepatobiliary phase is strongly associated with marked activation of the β-catenin pathway in hepatocellular adenoma, and its use might improve hepatocellular adenoma subtyping on MRI. KEY POINTS • Tumor uptake on hepatobiliary phase in both the visual and quantitative analyses had a specificity higher than 90% for the detection of marked β-catenin activation in hepatocellular adenoma. • However, the sensitivity of visual analysis alone is inferior to that of LLCER quantification on HBP due to the high number of HCAs with signal hyperintensity on HBP, especially those developed on underlying liver steatosis.
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Affiliation(s)
- E Reizine
- Department of Radiology, APHP, HU Henri Mondor, Créteil, Val-de-Marne, France.
| | - M Ronot
- Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France
| | - M Ghosn
- Department of Radiology, APHP, HU Henri Mondor, Créteil, Val-de-Marne, France
| | - J Calderaro
- Department of Pathology, APHP, HU Henri Mondor, Créteil, Val-de-Marne, France.,Faculté de Médecine, Universite Paris Est Creteil, 94010, Créteil, France.,INSERM Unit U 955, Equipe 18, 94010, Créteil, France
| | - N Frulio
- CHU Bordeaux Department of Diagnostic and Interventional Radiology, Université de Bordeaux, 33000, Bordeaux, France
| | - P Bioulac-Sage
- Inserm, UMR1053 Bordeaux Research in Translational Oncology, BaRITOn, Université de Bordeaux, 33076, Bordeaux, France.,Department of Pathology, Pellegrin Hospital, CHU de Bordeaux, 33076, Bordeaux, France
| | - H Trillaud
- Department of Pathology, Beaujon Hospital, APHP, Clichy, France
| | - V Vilgrain
- Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France.,INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France
| | - V Paradis
- INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France.,Department of Pathology, Beaujon Hospital, APHP, Clichy, France
| | - A Luciani
- Department of Radiology, APHP, HU Henri Mondor, Créteil, Val-de-Marne, France.,Faculté de Médecine, Universite Paris Est Creteil, 94010, Créteil, France.,INSERM Unit U 955, Equipe 18, 94010, Créteil, France
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Azoulay A, Cros J, Vullierme MP, de Mestier L, Couvelard A, Hentic O, Ruszniewski P, Sauvanet A, Vilgrain V, Ronot M. Morphological imaging and CT histogram analysis to differentiate pancreatic neuroendocrine tumor grade 3 from neuroendocrine carcinoma. Diagn Interv Imaging 2020; 101:821-830. [PMID: 32709455 DOI: 10.1016/j.diii.2020.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare morphological imaging features and CT texture histogram parameters between grade 3 pancreatic neuroendocrine tumors (G3-NET) and neuroendocrine carcinomas (NEC). MATERIALS AND METHODS Patients with pathologically proven G3-NET and NEC, according to the 2017 World Health Organization classification who had CT and MRI examinations between 2006-2017 were retrospectively included. CT and MRI examinations were reviewed by two radiologists in consensus and analyzed with respect to tumor size, enhancement patterns, hemorrhagic content, liver metastases and lymphadenopathies. Texture histogram analysis of tumors was performed on arterial and portal phase CT images. images. Morphological imaging features and CT texture histogram parameters of G3-NETs and NECs were compared. RESULTS Thirty-seven patients (21 men, 16 women; mean age, 56±13 [SD] years [range: 28-82 years]) with 37 tumors (mean diameter, 60±46 [SD] mm) were included (CT available for all, MRI for 16/37, 43%). Twenty-three patients (23/37; 62%) had NEC and 14 patients (14/37; 38%) had G3-NET. NECs were larger than G3-NETs (mean, 70±51 [SD] mm [range: 18 - 196mm] vs. 42±24 [SD] mm [range: 8 - 94mm], respectively; P=0.039), with more tumor necrosis (75% vs. 33%, respectively; P=0.030) and lower attenuation on precontrast (30±4 [SD] HU [range: 25-39 HU] vs. 37±6 [SD] [range: 25-45 HU], respectively; P=0.002) and on portal venous phase CT images (75±18 [SD] HU [range: 43 - 108 HU] vs. 92±19 [SD] HU [range: 46 - 117 HU], respectively; P=0.014). Hemorrhagic content on MRI was only observed in NEC (P=0.007). The mean ADC value was lower in NEC ([1.1±0.1 (SD)]×10-3 mm2/s [range: (0.91 - 1.3)×10-3 mm2/s] vs. [1.4±0.2 (SD)]×10-3 mm2/s [range: (1.1 - 1.6)×10-3 mm2/s]; P=0.005). CT histogram analysis showed that NEC were more heterogeneous on portal venous phase images (Entropy-0: 4.7±0.2 [SD] [range: 4.2-5.1] vs. 4.5±0.4 [SD] [range: 3.7-4.9]; P=0.023). CONCLUSION Pancreatic NECs are larger, more frequently hypoattenuating and more heterogeneous with hemorrhagic content than G3-NET on CT and MRI.
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Affiliation(s)
- A Azoulay
- Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France
| | - J Cros
- Department of Pathology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France; Université de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France
| | - M-P Vullierme
- Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France
| | - L de Mestier
- Université de Paris, Diderot Paris 7, 75010 Paris, France; Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France; INSERM U1149, CRI, Paris, France
| | - A Couvelard
- Department of Pathology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France; Université de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France
| | - O Hentic
- Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France
| | - P Ruszniewski
- Université de Paris, Diderot Paris 7, 75010 Paris, France; Department of Pancreatology, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France; INSERM U1149, CRI, Paris, France
| | - A Sauvanet
- Department of HPB Surgery, University Hospitals Paris Nord Val de Seine, Beaujon Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France
| | - V Vilgrain
- Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France; Université de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France
| | - M Ronot
- Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Assistance Publique-Hôpitaux de Paris, 92118 Clichy, France; Université de Paris, Diderot Paris 7, 75010 Paris, France; INSERM U1149, CRI, Paris, France.
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5
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Hobeika C, Cauchy F, Sartoris R, Beaufrère A, Yoh T, Vilgrain V, Rautou PE, Paradis V, Bouattour M, Ronot M, Soubrane O. Relevance of liver surface nodularity for preoperative risk assessment in patients with resectable hepatocellular carcinoma. Br J Surg 2020; 107:878-888. [PMID: 32118298 DOI: 10.1002/bjs.11511] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/08/2019] [Accepted: 12/14/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Quantification of liver surface nodularity (LSN) on routine preoperative CT images allows detection of cirrhosis and clinically significant portal hypertension. This study aimed to assess the relevance of LSN in preoperative assessment of operative risks for patients with resectable hepatocellular carcinoma (HCC). METHODS All patients undergoing hepatectomy for HCC between 2012 and 2017 were analysed retrospectively. LSN was assessed at the liver-fat interface on the left liver lobe on preoperative CT images. The feasibility of LSN quantification was assessed. The association between LSN and outcomes (severe complications and posthepatectomy liver failure (PHLF)) was evaluated by multivariable analysis and after propensity score matching. RESULTS Among 210 patients, LSN measurement was successful in 187 (89·0 per cent). Among these, the median LSN score was 2·42 (i.q.r. 2·21-2·66) and 52·9 per cent had severe fibrosis, including 33·7 per cent with cirrhosis. LSN score increased with hepatic venous pressure gradient (P = 0·048), severity of steatosis (P = 0·011) and fibrosis grade (P = 0·001). LSN score was independently associated with severe complications (odds ratio (OR) 5·25; P = 0·006) and PHLF (OR 6·78; P = 0·003). After matching with respect to model for end-stage liver disease, aspartate aminotransferase-to-platelet ratio index and fibrosis-4 score, patients with a LSN score of 2·63 or higher retained an increased risk of PHLF (OR 5·81; P = 0·018). In the subgroup of patients without severe fibrosis, LSN was accurate in predicting severe complications (P = 0·005). Patients with (P = 0·039) or without (P = 0·018) severe fibrosis with increased LSN score had a higher comprehensive complication index score. Among patients with cirrhosis who had clinically significant portal hypertension, a LSN value below 2·63 ruled out the risk of PHLF. CONCLUSION LSN measurement represents a practical tool that may allow improvement in the preoperative evaluation and management of patients with HCC.
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Affiliation(s)
- C Hobeika
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - F Cauchy
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - R Sartoris
- Department of Radiology, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - A Beaufrère
- Department of Pathology, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - T Yoh
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - V Vilgrain
- Department of Radiology, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - P E Rautou
- Department of Hepatology, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - V Paradis
- Department of Pathology, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - M Bouattour
- Department of Hepatology, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - M Ronot
- Department of Radiology, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
| | - O Soubrane
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique Hôpitaux de Paris and Université de Paris, Clichy, France
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Barat M, Paisant A, Calame P, Purcell Y, Lagadec M, Curac S, Zappa M, Vilgrain V, Ronot M. Unenhanced CT for clinical triage of elderly patients presenting to the emergency department with acute abdominal pain. Diagn Interv Imaging 2019; 100:709-719. [DOI: 10.1016/j.diii.2019.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/28/2019] [Accepted: 05/18/2019] [Indexed: 02/06/2023]
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Palmer D, Hawkins N, Vilgrain V, Pereira H, Chatellier G, Ross P. Selection of patients with hepatocellular carcinoma for selective internal radiation therapy based on tumour burden and liver function: A post-hoc analysis of the SARAH trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hawkins N, Ross P, Palmer D, Chatellier G, Pereira H, Vilgrain V. Overall survival of patients with hepatocellular carcinoma receiving sorafenib versus selective internal radiation therapy with predicted osimetry in the SARAH trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Cartier V, Crouan A, Esvan M, Oberti F, Michalak S, Gallix B, Seror O, Paisant A, Vilgrain V, Aubé C, Anty R, Archambeaud I, Baudin G, Brun V, Chevallier P, Cuilleron M, Dumortie J, Duvoux C, Estivalet L, Frampas E, Gandon Y, Guillygomarc’h A, Guiu B, Lebigot J, Le Pennec V, Luciani A, Minello A, Ollivier-Hourmand I, Pilleul F, Patouillard B, Sylvain C, Tasu J. Suspicious liver nodule in chronic liver disease: Usefulness of a second biopsy. Diagn Interv Imaging 2018; 99:493-499. [DOI: 10.1016/j.diii.2017.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/21/2017] [Accepted: 12/25/2017] [Indexed: 12/19/2022]
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Copin P, Zins M, Nuzzo A, Purcell Y, Beranger-Gibert S, Maggiori L, Corcos O, Vilgrain V, Ronot M. Erratum to "Acute mesenteric ischemia: A critical role for the radiologist" [Diagn. Interv. Imaging 99 (2018) 123-134]. Diagn Interv Imaging 2018; 99:345-346. [PMID: 29685732 DOI: 10.1016/j.diii.2018.03.006] [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] [Indexed: 10/17/2022]
Affiliation(s)
- P Copin
- Department of Radiology, University Hospitals Paris-Nord-Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France
| | - M Zins
- Department of Radiology, Groupe Hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - A Nuzzo
- University Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France; Department of Gastroenterology, University Hospitals Paris-Nord-Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France
| | - Y Purcell
- Department of Radiology, University Hospitals Paris-Nord-Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France
| | - S Beranger-Gibert
- Department of Radiology, Groupe Hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - L Maggiori
- University Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France; Department of Colorectal surgery, University Hospitals Paris-Nord-Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France
| | - O Corcos
- Department of Gastroenterology, University Hospitals Paris-Nord-Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France
| | - V Vilgrain
- Department of Radiology, University Hospitals Paris-Nord-Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France; Inserm U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 92110 Paris, France
| | - M Ronot
- Department of Radiology, University Hospitals Paris-Nord-Val-de-Seine, Beaujon, 92110 Clichy, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France; Inserm U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 92110 Paris, France.
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Affiliation(s)
- V Vilgrain
- Department of Radiology, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, AP-HP, Hauts-de-Seine, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France; Inserm U1149, CRI, Paris, France.
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12
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Copin P, Zins M, Nuzzo A, Purcell Y, Beranger-Gibert S, Maggiori L, Corcos O, Vilgrain V, Ronot M. Acute mesenteric ischemia: A critical role for the radiologist. Diagn Interv Imaging 2018; 99:123-134. [DOI: 10.1016/j.diii.2018.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 01/16/2018] [Accepted: 01/18/2018] [Indexed: 12/13/2022]
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13
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Elkrief L, Ronot M, Andrade F, Dioguardi Burgio M, Issoufaly T, Zappa M, Roux O, Bissonnette J, Payancé A, Lebrec D, Francoz C, Soubrane O, Valla D, Durand F, Vilgrain V, Castera L, Rautou PE. Non-invasive evaluation of portal hypertension using shear-wave elastography: analysis of two algorithms combining liver and spleen stiffness in 191 patients with cirrhosis. Aliment Pharmacol Ther 2018; 47:621-630. [PMID: 29322599 DOI: 10.1111/apt.14488] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 09/28/2017] [Accepted: 12/05/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Two algorithms based on sequential measurements of liver and spleen stiffness using two-dimensional shearwave elastography (2D-SWE) have been recently proposed to estimate clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] ≥10 mm Hg) in patients with cirrhosis, with excellent diagnostic accuracy. AIM To validate externally these algorithms in a large cohort of patients with cirrhosis. METHODS One hundred and ninety-one patients with stable cirrhosis (Child-Pugh class A 39%, B 29% and C 31%) who underwent liver and spleen stiffness measurements using 2D-SWE at the time of HVPG measurement were included. Diagnostic accuracy of the 2 algorithms was assessed by calculating sensitivity, specificity, positive and negative predictive values. RESULTS The first algorithm, using liver stiffness <16.0 kilopascals (kPa) and then spleen stiffness <26.6 kPa, was used to rule-out HVPG ≥10 mm Hg. In our population, its sensitivity and negative predictive value were 95% and 63% respectively. The second algorithm, using liver stiffness >38.0 kPa, or liver stiffness ≤38.0 kPa but spleen stiffness >27.9 kPa, was used to rule-in HVPG ≥10 mm Hg. In our population, its specificity and positive predictive value were 52% and 83% respectively. Restricting the analyses to the 74 patients without any history of decompensation of cirrhosis or to the 65 patients with highly reliable liver stiffness measurement did not improve the results. CONCLUSION In our population, diagnostic accuracies of non-invasive algorithms based on sequential measurements of liver and spleen stiffness using 2D-SWE were acceptable, but not good enough to replace HVPG measurement or to base clinical decisions.
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Affiliation(s)
- L Elkrief
- Service d'Hépatologie et Gastroentérologie, Hôpitaux Universitaires de Genève, Suisse, Switzerland.,Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - M Ronot
- Service de radiologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - F Andrade
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - M Dioguardi Burgio
- Service de radiologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - T Issoufaly
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - M Zappa
- Service de radiologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - O Roux
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - J Bissonnette
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - A Payancé
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - D Lebrec
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - C Francoz
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - O Soubrane
- UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris.,Service de chirurgie digestive, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - D Valla
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - F Durand
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - V Vilgrain
- Service de radiologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - L Castera
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR 1149, Inserm, Université Paris Diderot Paris 7, Centre de Recherche sur l' Inflammation (CRI), Paris
| | - P-E Rautou
- Service d'Hépatologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France.,UMR-970, Paris Cardiovascular Research Center - PARCC, INSERM, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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Pupulim L, Ronot M, Paradis V, Chemouny S, Vilgrain V. Volumetric measurement of hepatic tumors: Accuracy of manual contouring using CT with volumetric pathology as the reference method. Diagn Interv Imaging 2018; 99:83-89. [DOI: 10.1016/j.diii.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/31/2017] [Accepted: 11/19/2017] [Indexed: 01/16/2023]
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Laurent L, Lemaitre C, Minello A, Plessier A, Lamblin G, Poujol-Robert A, Gervais-Hasenknopf A, Pariente EA, Belenotti P, Mostefa-Kara N, Sogni P, Legrand M, Cournac JM, Tamion F, Savoye G, Bedossa P, Valla DC, Vilgrain V, Goria O. Cholangiopathy in critically ill patients surviving beyond the intensive care period: a multicentre survey in liver units. Aliment Pharmacol Ther 2017; 46:1070-1076. [PMID: 29023905 DOI: 10.1111/apt.14367] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 06/29/2017] [Accepted: 09/18/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND The outcome of cholangiopathy developing in intensive care unit (ICU) is not known in patients surviving their ICU stay. AIM To perform a survey in liver units, in order to clarify the course of cholangiopathy after surviving ICU stay. METHODS The files of the liver units affiliated to the French network for vascular liver disease were screened for cases of ICU cholangiopathy developing in patients with normal liver function tests on ICU admission, and no prior history of liver disease. RESULTS Between 2005 and 2015, 16 cases were retrieved. Extensive burns were the cause for admission to ICU in 11 patients. Serum alkaline phosphatase levels increased from day 11 (2-46) to a peak of 15 (4-32) × ULN on day 81 (12-511). Magnetic resonance cholangiography showed irregularities or frank stenosis of the intrahepatic ducts, and proximal extrahepatic ducts contrasting with a normal aspect of the distal common bile duct. Follow-up duration was 20.6 (4.7-71.8) months. Three patients were lost to follow-up; 2 patients died from liver failure and no patient was transplanted. One patient had worsening strictures of the intrahepatic bile ducts with jaundice. Nine patients had persistent but minor strictures of the intrahepatic bile ducts on MR cholangiography, and persistent cholestasis without jaundice. One patient had normal liver function tests. CONCLUSIONS In patients surviving their ICU stay, ICU cholangiopathy is not uniformly fatal in the short term or clinically symptomatic in the medium term. Preservation of the distal common bile duct appears to be a finding differentiating ICU cholangiopathy from other diffuse cholangiopathies.
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Leporq B, Lambert SA, Ronot M, Vilgrain V, Van Beers BE. Simultaneous MR quantification of hepatic fat content, fatty acid composition, transverse relaxation time and magnetic susceptibility for the diagnosis of non-alcoholic steatohepatitis. NMR Biomed 2017; 30:e3766. [PMID: 28678410 DOI: 10.1002/nbm.3766] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/10/2017] [Accepted: 05/30/2017] [Indexed: 06/07/2023]
Abstract
Non-alcoholic steatohepatitis (NASH) is characterized at histology by steatosis, hepatocyte ballooning and inflammatory infiltrates, with or without fibrosis. Although diamagnetic material in fibrosis and inflammation can be detected with quantitative susceptibility imaging, fatty acid composition changes in NASH relative to simple steatosis have also been reported. Therefore, our aim was to develop a single magnetic resonance (MR) acquisition and post-processing scheme for the diagnosis of steatohepatitis by the simultaneous quantification of hepatic fat content, fatty acid composition, T2 * transverse relaxation time and magnetic susceptibility in patients with non-alcoholic fatty liver disease. MR acquisition was performed at 3.0 T using a three-dimensional, multi-echo, spoiled gradient echo sequence. Phase images were unwrapped to compute the B0 field inhomogeneity (ΔB0 ) map. The ΔB0 -demodulated real part images were used for fat-water separation, T2 * and fatty acid composition quantification. The external and internal fields were separated with the projection onto dipole field method. Susceptibility maps were obtained after dipole inversion from the internal field map with single-orientation Bayesian regularization including spatial priors. Method validation was performed in 32 patients with biopsy-proven, non-alcoholic fatty liver disease from which 12 had simple steatosis and 20 NASH. Liver fat fraction and T2 * did not change significantly between patients with simple steatosis and NASH. In contrast, the saturated fatty acid fraction increased in patients with NASH relative to patients with simple steatosis (48 ± 2% versus 44 ± 4%; p < 0.05) and the magnetic susceptibility decreased (-0.30 ± 0.27 ppm versus 0.10 ± 0.14 ppm; p < 0.001). The area under the receiver operating characteristic curve for magnetic susceptibility as NASH marker was 0.91 (95% CI: 0.79-1.0). Simultaneous MR quantification of fat content, fatty acid composition, T2 * and magnetic susceptibility is feasible in the liver. Our preliminary results suggest that quantitative susceptibility imaging has a high diagnostic performance for the diagnosis of NASH.
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Affiliation(s)
- B Leporq
- Laboratory of Imaging Biomarkers, Center of Research on Inflammation, UMR 1149 Inserm, University Paris Diderot, Sorbonne Paris Cité, Paris, France
- Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé, CNRS UMR 5220, Inserm U1209, UCBL Lyon 1, INSA-Lyon, Université de Lyon, France
| | - S A Lambert
- Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé, CNRS UMR 5220, Inserm U1209, UCBL Lyon 1, INSA-Lyon, Université de Lyon, France
| | - M Ronot
- Laboratory of Imaging Biomarkers, Center of Research on Inflammation, UMR 1149 Inserm, University Paris Diderot, Sorbonne Paris Cité, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, Clichy, France
| | - V Vilgrain
- Laboratory of Imaging Biomarkers, Center of Research on Inflammation, UMR 1149 Inserm, University Paris Diderot, Sorbonne Paris Cité, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, Clichy, France
| | - B E Van Beers
- Laboratory of Imaging Biomarkers, Center of Research on Inflammation, UMR 1149 Inserm, University Paris Diderot, Sorbonne Paris Cité, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, Clichy, France
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Lassau N, Coiffier B, Kind M, Vilgrain V, Lacroix J, Cuinet M, Taieb S, Aziza R, Sarran A, Labbe-Devilliers C, Gallix B, Lucidarme O, Ptak Y, Rocher L, Caquot LM, Chagnon S, Marion D, Luciani A, Feutray S, Uzan-Augui J, Benatsou B, Bonastre J, Koscielny S. Selection of an early biomarker for vascular normalization using dynamic contrast-enhanced ultrasonography to predict outcomes of metastatic patients treated with bevacizumab. Ann Oncol 2016; 27:1922-8. [PMID: 27502701 DOI: 10.1093/annonc/mdw280] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 02/24/2016] [Accepted: 07/06/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Dynamic contrast-enhanced ultrasonography (DCE-US) has been used for evaluation of tumor response to antiangiogenic treatments. The objective of this study was to assess the link between DCE-US data obtained during the first week of treatment and subsequent tumor progression. PATIENTS AND METHODS Patients treated with antiangiogenic therapies were included in a multicentric prospective study from 2007 to 2010. DCE-US examinations were available at baseline and at day 7. For each examination, a 3 min perfusion curve was recorded just after injection of a contrast agent. Each perfusion curve was modeled with seven parameters. We analyzed the correlation between criteria measured up to day 7 on freedom from progression (FFP). The impact was assessed globally, according to tumor localization and to type of treatment. RESULTS The median follow-up was 20 months. The mean transit time (MTT) evaluated at day 7 was the only criterion significantly associated with FFP (P = 0.002). The cut-off point maximizing the difference between FFP curves was 12 s. Patients with at least a 12 s MTT had a better FFP. The results according to tumor type were significantly heterogeneous: the impact of MTT on FFP was more marked for breast cancer (P = 0.004) and for colon cancer (P = 0.025) than for other tumor types. Similarly, the differences in FFP according to MTT at day 7 were marked (P = 0.004) in patients receiving bevacizumab. CONCLUSION The MTT evaluated with DCE-US at day 7 is significantly correlated to FFP of patients treated with bevacizumab. This criterion might be linked to vascular normalization. AFSSAPS NO 2007-A00399-44.
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Affiliation(s)
- N Lassau
- Gustave Roussy, Université Paris-Saclay, Imaging Department, Villejuif, and IR4M, Centre National de la Recherche Scientifique, Université Paris-Sud, Université Paris-Saclay, Villejuif
| | - B Coiffier
- Gustave Roussy, Université Paris-Saclay, Imaging Department, Villejuif, and IR4M, Centre National de la Recherche Scientifique, Université Paris-Sud, Université Paris-Saclay, Villejuif
| | - M Kind
- Imaging Department, Institut Bergonié, Bordeaux
| | - V Vilgrain
- Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, Clichy
| | - J Lacroix
- Radiology Department, Centre François Baclesse, Caen
| | - M Cuinet
- Radiology Department, Centre Léon Bérard, Lyon
| | - S Taieb
- Radiology Department, Centre Oscar Lambret, Lille
| | - R Aziza
- Radiodiagnostics Department, Centre Claudius Regaud, Toulouse
| | - A Sarran
- Imaging Department, Institut Paoli Calmettes, Marseille
| | | | - B Gallix
- Department of Abdominal and Digestive Imaging, Hôpital Saint-Eloi, Montpellier and Department of Radiology, McGill University Health Center, Montreal, Canada
| | - O Lucidarme
- Radiology Department, CHU La Pitié-Salpêtrière, Paris
| | - Y Ptak
- Radiodiagnostics Department, Centre Jean Perrin, Clermont-Ferrand
| | - L Rocher
- Radiology Department, CHU Bicêtre, Le Kremlin-Bicêtre
| | - L M Caquot
- Radiodiagnostics and Imaging Department, Institut Jean Godinot, Reims
| | - S Chagnon
- Radiology Department, Hôpital Ambroise Paré, Boulogne-Billancourt
| | - D Marion
- Radiology Department, CHU Hôtel-Dieu, Lyon
| | - A Luciani
- Radiology Department, CHU Henri Mondor, Créteil
| | - S Feutray
- Radiology Department, Centre Georges-François Leclerc, Dijon
| | | | - B Benatsou
- Gustave Roussy, Université Paris-Saclay, Imaging Department, Villejuif, and IR4M, Centre National de la Recherche Scientifique, Université Paris-Sud, Université Paris-Saclay, Villejuif
| | - J Bonastre
- Service biostatistique et épidémiologie, Gustave Roussy and CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud Univ., Villejuif, France
| | - S Koscielny
- Service biostatistique et épidémiologie, Gustave Roussy and CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Paris-Sud Univ., Villejuif, France
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Chassagnon G, Dangouloff-Ros V, Vilgrain V, Ronot M. Academic productivity of French radiology residents: Where do we stand? Diagn Interv Imaging 2016; 97:211-8. [DOI: 10.1016/j.diii.2015.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/02/2015] [Accepted: 08/06/2015] [Indexed: 11/24/2022]
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Neri E, Bali MA, Ba-Ssalamah A, Boraschi P, Brancatelli G, Alves FC, Grazioli L, Helmberger T, Lee JM, Manfredi R, Martì-Bonmatì L, Matos C, Merkle EM, Op De Beeck B, Schima W, Skehan S, Vilgrain V, Zech C, Bartolozzi C. ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents. Eur Radiol 2015; 26:921-31. [PMID: 26194455 PMCID: PMC4778143 DOI: 10.1007/s00330-015-3900-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 06/07/2015] [Accepted: 06/22/2015] [Indexed: 02/06/2023]
Abstract
Objectives To develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents. Methods The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach’s statistics were used to rate levels of agreement and internal reliability of the consensus. Results Three Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases. Conclusions The consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases. Key points • Liver-specific contrast agents are recommended in MRI of the liver. • The hepatobiliary phase improves the detection and characterization of hepatocellular lesions. • Liver-specific contrast agents can improve the detection of HCC.
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Affiliation(s)
- E Neri
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy.
| | - M A Bali
- Department of Radiology, Hôpital Erasme, MRI Clinics, Bruxelles, Belgium
| | - A Ba-Ssalamah
- Department of Biomedical Imaging and Image-guided Therapy, The General Hospital of the Medical University of Vienna, Vienna, Austria
| | - P Boraschi
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
| | - G Brancatelli
- Department of Radiology, University of Palermo, Palermo, Italy
| | - F Caseiro Alves
- Medical Imaging Department and Faculty of Medicine, University Hospital of Coimbra, Coimbra, Portugal
| | - L Grazioli
- Department of Radiology, Spedali Civili di Brescia, Brescia, Italy
| | - T Helmberger
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Academic Teaching Hospital of the Technical University, Munich, Germany
| | - J M Lee
- Division of Abdominal Imaging, Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - R Manfredi
- Department of Radiology, University of Verona, Verona, Italy
| | - L Martì-Bonmatì
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - C Matos
- Department of Radiology, Hôpital Erasme, MRI Clinics, Bruxelles, Belgium
| | - E M Merkle
- Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Switzerland
| | - B Op De Beeck
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium
| | - W Schima
- Department of Diagnostic and Interventional Radiology, KH Goettlicher Heiland, Krankenhaus der Barmherzigen Schwestern and Sankt Josef-Krankenhaus, Vienna, Austria
| | - S Skehan
- Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - V Vilgrain
- Radiology Department, Assistance Publique-Hôpitaux de Paris, APHP, Hôpital Beaujon, Clichy, Paris, France
| | - C Zech
- Abteilungsleiter Interventionelle Radiologie, Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Switzerland
| | - C Bartolozzi
- Department of Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
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Dangouloff-Ros V, Ronot M, Lagadec M, Vilgrain V. Analysis of subsequent publication of scientific orally presented abstracts of the French National Congress of Radiology. Part II: Focus on the French abstracts. Diagn Interv Imaging 2015; 96:467-76. [PMID: 25746221 DOI: 10.1016/j.diii.2015.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 12/12/2014] [Revised: 02/04/2015] [Accepted: 02/05/2015] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the publication rate of scientific abstracts that were presented orally at the 2008, 2009, and 2010 annual meetings of the French Society of Radiology by French radiologists, and to perform a French regional analysis. MATERIAL AND METHODS Orally presented abstracts were identified by examining online abstract books of the 2008, 2009, and 2010 annual meetings of the French Society of Radiology, and cross-checked by reviewing the paper version of abstracts for the same period. Only abstracts from French teams were selected. The administrative region of submission was noted for each abstract and for each region the total population, the number of active radiologists, the number of active members of the French Society of Radiology and the number of academic radiologists were noted. Imaging subspecialties were also noted. RESULTS 625 abstracts were identified resulting in 268 publications (publication rate: 43%). The median number of presentations and publications per region was 18 (range: 1-255) and 7 (range: 0-101), respectively. The ratio per million inhabitants was 7.5 and 3 respectively. The median number of presentations and publications per 100 active radiologists (respectively members of the FSR) was 7 and 3 (respectively 10 and 4). The median number of presentations and publications per academic radiologist were 2.6, and 1.2, respectively. The regional variations for each indicator were high (40-180%). Three subspecialties had a publication rate of more than 50%: thoracic imaging (58%), abdominal imaging (52%), and genitourinary imaging (51%). CONCLUSION The publication rate of orally presented French scientific abstracts was high, with important variations according to the regions of origin and imaging subspecialties.
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Affiliation(s)
- V Dangouloff-Ros
- Department of Radiology, University Hospitals Paris-Nord - Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France
| | - M Ronot
- Department of Radiology, University Hospitals Paris-Nord - Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France; University Paris Diderot, Sorbonne Paris Cité, 75010 Paris, France; INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 75018 Paris, France.
| | - M Lagadec
- Department of Radiology, University Hospitals Paris-Nord - Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France; University Paris Diderot, Sorbonne Paris Cité, 75010 Paris, France; INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 75018 Paris, France
| | - V Vilgrain
- Department of Radiology, University Hospitals Paris-Nord - Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France; University Paris Diderot, Sorbonne Paris Cité, 75010 Paris, France; INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 75018 Paris, France
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Dangouloff-Ros V, Ronot M, Lagadec M, Vilgrain V. Analysis of subsequent publication of scientific orally presented abstracts of the French national congress of radiology. Part I: General characteristics. Diagn Interv Imaging 2015; 96:461-6. [PMID: 25746222 DOI: 10.1016/j.diii.2015.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/04/2015] [Accepted: 02/05/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the publication rate of scientific abstracts orally presented at the annual meeting of the French Society of Radiology (FSR), and to identify factors associated with publication. MATERIAL AND METHODS Abstracts were selected from the books of abstracts of the 2008-2010 annual meetings of the FSR. For each abstract, country of origin, diagnostic/interventional radiology, imaging techniques (plain radiography, angiography, ultrasound [US], computed tomography [CT], magnetic resonance imaging [MRI]), human/experimental study, retrospective/prospective design, number of subjects, oncologic study or not were noted. Publications were searched in Medline-indexed journals and factors associated analyzed by multivariate analysis. RESULTS Seven hundred and forty-four abstracts lead to 298 publications (publication rate 40%). Most abstracts reported retrospective studies (61%), in humans (94%), diagnostic imaging (85%), from European authors (90%), and oncology (27%). Median number of subject was 39 (19-87). Main imaging techniques were MRI, CT, US (46%, 29%, 21%). Publications were mostly in English (89%), in radiological journals (72%), with a mean 3.5±3.7 impact factor. Publication was associated with a prospective design (OR=1.80), a submission from Europe (OR=1.71), angiography (OR=2.44), and oncology (OR=1.81). CONCLUSION The annual meeting of the FSR is in French, but the rate of publication of presented abstracts is high, mostly in English in reputable journals.
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Affiliation(s)
- V Dangouloff-Ros
- Department of radiology, university hospitals Paris Nord-Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France
| | - M Ronot
- Department of radiology, university hospitals Paris Nord-Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France; University Paris-Diderot, sorbonne Paris-Cité, 75012 Paris, France; Inserm U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 75018 Paris, France.
| | - M Lagadec
- Department of radiology, university hospitals Paris Nord-Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France; University Paris-Diderot, sorbonne Paris-Cité, 75012 Paris, France; Inserm U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 75018 Paris, France
| | - V Vilgrain
- Department of radiology, university hospitals Paris Nord-Val-de-Seine, Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France; University Paris-Diderot, sorbonne Paris-Cité, 75012 Paris, France; Inserm U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, 75018 Paris, France
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Colleter L, Corcos O, Vilgrain V, Ronot M. A rare cause of abdominal pain. Diagn Interv Imaging 2014. [DOI: 10.1016/j.diii.2014.02.013] [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] [Indexed: 10/25/2022]
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Fuks D, Voitot H, Paradis V, Belghiti J, Vilgrain V, Farges O. Intracystic concentrations of tumour markers for the diagnosis of cystic liver lesions. Br J Surg 2014; 101:408-16. [PMID: 24477793 DOI: 10.1002/bjs.9414] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Imaging occasionally fails to differentiate hepatic simple cysts from malignant or premalignant mucinous cystic lesions such as biliary cystadenomas. Hepatic simple cysts can be treated conservatively, whereas malignant or premalignant cysts require complete resection. This study assessed the ability of intracystic tumour marker concentrations to differentiate these disease entities. METHODS Intracystic fluid was sampled in patients undergoing partial or complete resection of a cystic lesion of the liver. The indication for surgery in hepatic simple cysts was symptoms or suspicion of a biliary cystadenoma. Intracystic concentrations of carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9 and tumour-associated glycoprotein (TAG) 72 were measured to assess the diagnostic accuracy of these tumour markers. Cut-off values were defined by receiver operating characteristic (ROC) curves. RESULTS The study population comprised 118 patients (94 women) with a median age of 59 years. There were 75 patients with hepatic simple cysts, 27 with mucinous cysts (19 biliary cystadenomas, 4 biliary cystadenocarcinomas, 4 intraductal papillary mucinous neoplasms of the bile duct) and 16 with miscellaneous cysts. Unlike CEA and CA19-9, a TAG-72 concentration of more than 25 units/ml differentiated hepatic simple cysts from mucinous cysts with a sensitivity and a specificity of 0·79 and 0·97 respectively. The area under the ROC curve was 0·98 for mucinous versus hepatic simple cysts. CONCLUSION The concentration of TAG-72 in cyst fluid accurately identified hepatic cysts that required complete resection.
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Affiliation(s)
- D Fuks
- Departments of Hepatobiliary Surgery, Hôpital Beaujon, Assistance Publique - Hôpitaux de Paris, Pôle des Maladies de l'Appareil Digestif, Université Paris 7, Clichy, France
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Wagner M, Zappa M, Maggiori L, Bretagnol F, Vilgrain V, Panis Y. Can postoperative complications be predicted by a routine CT scan on day 5? A study of 78 laparoscopic colorectal resections. Tech Coloproctol 2013; 18:239-45. [PMID: 23860629 DOI: 10.1007/s10151-013-1047-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 07/01/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Postoperative computed tomography (CT) scan patterns after colorectal resection are difficult to analyze for both clinicians and radiologists. This study aimed to assess the role of single CT scan on postoperative day 5 in predicting postoperative morbidity. METHODS From October 2007 to August 2009, 78 patients undergoing laparoscopic colorectal resection were enrolled in a research study involving a routine contrast-enhanced multi-detector CT scan on postoperative day 5. Two groups were defined: patients with intra-abdominal postoperative morbidity requiring specific management, i.e., surgical or radiological procedure, and/or antibiotic therapy ("complications" group), and patients with uneventful postoperative outcome ("uneventful" group). CT findings were compared between the two groups with Fisher's exact test or chi-square test. RESULTS Postoperative abdominal complications occurred in 16 patients (21 %). Of the CT findings on day 5, pneumonia, pulmonary embolism, portal or mesenteric thrombosis, operative area fat infiltration, peritoneal effusion, pneumoperitoneum, intra-abdominal collection, parietal inflammation or collection, and subcutaneous emphysema were observed in both groups without any significant difference. Only small bowel distension [25 % (4/16) in the "complications" group vs. 5 % (3/62) in the "uneventful" group; p = 0.029] and pleural effusion [81 % (13/16) vs. 48 % (30/62); p = 0.024, respectively] were observed significantly more often in the "complications" group. CONCLUSIONS This study suggested that abdominal complications cannot be predicted by a CT scan on day 5 after laparoscopic colorectal resection. Thus, it cannot be recommended for routine use.
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Affiliation(s)
- M Wagner
- Department of Radiology, Beaujon Hospital, Universitary Hospitals Paris Nord Val de Seine, Beaujon, Clichy Cedex, France
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Vilgrain V, Ronot M, Abdel-Rehim M, Zappa M, d’Assignies G, Bruno O, Vullierme MP. Hepatic steatosis: A major trap in liver imaging. Diagn Interv Imaging 2013; 94:713-27. [DOI: 10.1016/j.diii.2013.03.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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27
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Soyer P, Kanematsu M, Taouli B, Koh DM, Manfredi R, Vilgrain V, Hoeffel C, Guiu B. ADC normalization: a promising research track for diffusion-weighted MR imaging of the abdomen. Diagn Interv Imaging 2013; 94:571-3. [PMID: 23731499 DOI: 10.1016/j.diii.2013.05.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Pupulim LF, Vullierme MP, Paradis V, Valla D, Terraz S, Vilgrain V. Congenital portosystemic shunts associated with liver tumours. Clin Radiol 2013; 68:e362-9. [PMID: 23537576 DOI: 10.1016/j.crad.2013.01.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 01/16/2013] [Accepted: 01/22/2013] [Indexed: 12/30/2022]
Abstract
AIM To evaluate the diagnosis and presentation of liver tumours in patients with congenital portosystemic shunts (CPS). MATERIALS AND METHODS Eight patients were diagnosed in Hôpital Beaujon as having CPS. All patients underwent Doppler ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and histological examination of liver tumours. CPS were classified according to anatomy and the amount of portal flow deviated to the systemic circulation as: total, subtotal, or partial. Liver tumours were diagnosed by needle core biopsy (n = 5) or surgery (n = 3). Clinical follow-up was available in all patients but one (mean follow-up 36 months; range 1-5 years). RESULTS Six patients had total CPS, one patient had a subtotal CPS, and the last had a partial CPS. All patients presented with multiple liver nodules (range four to >15). The tumours were characterized as focal nodular hyperplasia (FNH; n = 4), FNH with hepatocellular adenoma (n = 2), and regenerative nodular hyperplasia (n = 2). In four of seven patients (57%) that had follow-up, tumours showed enlargement or new lesions appeared. CONCLUSION In this series of CPS patients, tumours were all benign, multiple, and of hepatocellular origin, and different tumours were present simultaneously in two patients. Tumour enlargement or new nodules were common during follow-up.
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Affiliation(s)
- L F Pupulim
- Department of Radiology, Hôpital Beaujon, Assistance Publique des Hôpitaux de Paris, Université Paris Diderot, Sorbonne Paris Cité, INSERM unité 773 CRB3, Paris, France.
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Poujade O, Daher A, Ballout El Maoula A, Aflak N, Bougeois B, Vilgrain V, Luton D. Nécrose utérine après embolisation pelvienne pour hémorragie du postpartum : à propos d’un cas. ACTA ACUST UNITED AC 2012; 41:584-6. [DOI: 10.1016/j.jgyn.2012.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 03/26/2012] [Accepted: 04/10/2012] [Indexed: 10/28/2022]
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Lencioni R, Izzo F, Crocetti L, Vilgrain V, Abdel-Rehim M, Bianchi L, Ricke J, Pech M, Bruix J. Abstract No LB12: A prospective, multicenter phase II clinical trial using irreversible electroporation for the treatment of early stage HCC. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2012.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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31
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Eurin M, Haddad N, Zappa M, Lenoir T, Dauzac C, Vilgrain V, Mantz J, Paugam-Burtz C. Incidence and predictors of missed injuries in trauma patients in the initial hot report of whole-body CT scan. Injury 2012; 43:73-7. [PMID: 21663908 DOI: 10.1016/j.injury.2011.05.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 05/19/2011] [Accepted: 05/19/2011] [Indexed: 02/02/2023]
Abstract
BACKGROUND Whole-body CT scan is the cornerstone of trauma-related injury assessment. Several lines of evidence indicate that significant number of injuries may remain undetected after the initial hot report of CT. Missed injuries (MI) represent an important issue in trauma patients, for they may increase morbidity, mortality and costs. The aim of this study was to examine incidence and predictors of MI in trauma patients undergoing whole-body CT scan. METHODS 177 CT scan performed upon admission of trauma patients during year 2005 were reviewed by a radiologist blinded to patient's initial data. MI was defined as injuries not written in the initial report. Patients with and without MI were compared to determine predictors of MI by multivariable analysis. RESULTS 157 MI were diagnosed in 85 (47%) patients. MI was predominantly encoded AIS 2 (57%) or 3 (29%). Patients with MI had significantly higher SAPSII, higher ISS and were more frequently sedated. Age over 50 years (OR: 4.37, p=0.003) and ISS over 14 (OR: 4.17, p<0.0001) were independent predictors of MI. Median ISS after encoding MI was significantly higher than initial ISS (22 vs. 20 p<0.0001). After adjustment for severity, mortality and length of stay were not different between patients with or without MI. CONCLUSION Trauma patients, especially aged and severe, experienced a high rate of missed injuries in the initial hot report which appeared to be predominantly minor and musculoskeletal, advocating a CT scan second reading.
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Affiliation(s)
- M Eurin
- Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, Department of Anesthesiology and Critical Care, 92110 Clichy-la-Garenne, France
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Vilgrain V, Zappa M, Bruno O, Faivre S, Raymond E. 373 INVITED Novel Imaging Techniques and Treatment Assessment for Evaluating Benefit From Targeted Agents. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70588-3] [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] [Indexed: 11/28/2022]
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Lassau N, Vilgrain V, Kind M, Lacroix J, Cuinet M, Aziza R, Taieb S, Sarran A, Labbe C, Koscielny S. 805 ORAL Evaluation of Anti-angiogenic Treatments With DCE-US in 539 Patients – Results After 2 Years Median Follow-up. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70642-6] [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] [Indexed: 10/17/2022]
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34
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Vullierme MP, d'Assignies G, Ruszniewski P, Vilgrain V. Imaging IPMN: take home messages and news. Clin Res Hepatol Gastroenterol 2011; 35:426-9. [PMID: 21616741 DOI: 10.1016/j.clinre.2011.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 02/10/2011] [Accepted: 02/15/2011] [Indexed: 02/04/2023]
Abstract
IPMN is a frequent disease involving pancreatic duct. This disease could be malignant (parenchymal invasive adenocarcinoma), particularly if the main pancreatic duct is involved (this involvement is considered present if > 6 mm), if this enlargement reaches 10 mm or more, and if the pathological phenotype is biliopancreatic or intestinal (malignancy is less frequent if gastric one). Invasiveness is suspected if hypodense parenchymal lesion is present, particularly near a cystical lesion or MPD, a mural nodule of the wall, or if MPD wall has got a contrast uptake. Mural nodules inside cystic branch duct are associated with in situ grade 3 malignancies. MPD IPMN must be resected to prevent malignancy. The follow-up of isolated branch duct cysts relies upon MDCT and MRI, every two years if lesion is less than 1cm. Every one year if bigger, particularly if more than to 3 cm.
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Affiliation(s)
- M P Vullierme
- Radiology department, Beaujon hospital, 100, boulevard General-Leclerc, 92110 Clichy, France.
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35
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Lassau N, Koscielny S, Lacroix J, Cuinet M, Aziza R, Taieb S, Vilgrain V, Sarran A, Labbe C, Journeau F, Bonastre J, Soria J. Final results of a French multicentric prospective study of dynamic contrast-enhanced ultrasound (DCE-US) for the evaluation of antiangiogenic treatments in 537 patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13500] [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] [Indexed: 11/20/2022] Open
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36
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Belghiti J, Rau C, Blanc B, Ronot M, Dokmak S, Fuks D, Paradis V, Vilgrain V, Faivre SJ. Analysis of preoperative CT and peroperative evaluation as predictors of involvement of hepatic pedicle LN in patients operated for CRLM. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.375] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
375 Background: Approximately 20% of patients who undergo resection for colorectal liver metastases (CLM) have additional metastases present in hepatic pedicle lymph nodes (HPLN). Although LN status is a major prognostic factor, routine LN dissection is controversial. We evaluated the accuracy of preoperative CT scans and peroperative surgical assessment to determine if these methods could help determining which patients are at high risk for nodal metastases and should undergo lymphadenectomy. Methods: Between 01-2008 and 06-2010, 76 consecutive patients who underwent liver resection and lymphadenectomy for CLM after neoadjuvant chemotherapy were enrolled in a prospective study. All patients had recent (<1 month) preoperative CT to evaluate their liver metastases and the presence, location, size and radiologic characteristics of LN were assessed. Peroperatively, the size and consistency of LN were evaluated by the surgeon. Surgeons and radiologists independently assessed LN involvement. Results were compared to the definitive pathologic examination. Results: Among the 76 patients, 241 nodes were analyzed with a mean number of 3 (± 2) nodes removed per patient. Lymphadenectomy increased the surgical procedure by 20 minutes (12-25 min) and there was no specific morbidity or mortality related to LN clearance. Pathologic HPLN involvement was observed in 15 (20%) patients with a median number of 2 (1-6) metastatic nodes per patient. Peroperative assessment had a high negative predictive value (NPV) = 91% with a low positive predictive value (PPV) = 43%. CT scan assessment had also a NPV and PPV of 85% and 56%, respectively. When considering both peroperative and radiologic data, 27% of patients with pathologic LN involvement were not anticipated and 25% of patients who were node negative on pathologic examination had suspected LN involvement. Conclusions: A selective strategy limiting HPLN clearance to high risk patients relies on information from preoperative CT scans and eroperative surgical assessment. Given that both modalities cannot accurately predict nodal pathologic status, routine HPLN dissection should be performed in patients who undergo resection of CRLM. No significant financial relationships to disclose.
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Affiliation(s)
- J. Belghiti
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - C. Rau
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - B. Blanc
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - M. Ronot
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - S. Dokmak
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - D. Fuks
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - V. Paradis
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - V. Vilgrain
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
| | - S. J. Faivre
- Hôpital Beaujon, Clichy, France; Centre Hospitalier Universitaire de Beaujon, Clichy, France
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Lassau N, Lacroix J, Taieb S, Aziza R, Vilgrain V, Cuinet M, Sarran A, Labbe C, Jean-Pierre A, Koscielny S. French, multicentric, prospective study of dynamic contrast-enhanced ultrasound (DCE-US) for the evaluation of antiangiogenic treatments in 400 patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Campisi A, Brancatelli G, Vullierme MP, Levy P, Ruszniewski P, Vilgrain V. Corrigendum to: Are pancreatic calcifications specific for the diagnosis of chronic pancreatitis? A multidetector-row CT analysis. [64 (9) 903–911]. Clin Radiol 2009. [DOI: 10.1016/j.crad.2009.08.002] [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] [Indexed: 10/20/2022]
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Vullierme M, Sibert A, Abd El Rehim M, Vilgrain V. Stenoses biliaires focales : tout n’est pas un cancer. Journal de Radiologie 2009; 90:1224. [DOI: 10.1016/s0221-0363(09)74916-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Campisi A, Brancatelli G, Vullierme MP, Levy P, Ruzniewski P, Vilgrain V. Are pancreatic calcifications specific for the diagnosis of chronic pancreatitis? A multidetector-row CT analysis. Clin Radiol 2009; 64:903-11. [DOI: 10.1016/j.crad.2009.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 04/27/2009] [Accepted: 05/05/2009] [Indexed: 10/20/2022]
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Meskine N, Vullierme M, Zappa M, Gayet M, Sibert A, Vilgrain V. 6608 Evaluation of analgesic effect of N2O/O2 inhalation, during percutaneous biopsy of focal liver lesions: a randomized study. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71329-1] [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] [Indexed: 11/17/2022] Open
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Zappa M, Sibert A, Vullierme MP, Bertin C, Bruno O, Vilgrain V. Imagerie post-opératoire du péritoine et de la paroi abdominale. ACTA ACUST UNITED AC 2009; 90:969-79. [DOI: 10.1016/s0221-0363(09)73235-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Tranquart F, Correas JM, Ladam Marcus V, Manzoni P, Vilgrain V, Aube C, Elmaleh A, Chami L, Claudon M, Cuilleron M, Diris B, Garibaldi F, Lucidarme O, Marion D, Beziat C, Rode A, Tasu JP, Trillaud H, Bleuzen A, Le Gouge A, Giraudeau B, Rusch E. [Real-time contrast-enhanced ultrasound in the evaluation of focal liver lesions: diagnostic efficacy and economical issues from a French multicentric study]. ACTA ACUST UNITED AC 2009; 90:109-22. [PMID: 19212279 DOI: 10.1016/s0221-0363(09)70089-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The recent introduction of high-end ultrasound equipment combined with recent contrast agents provides marked improvements in the characterization of focal liver lesions as previously reported by monocentric studies. The aim of the present study was to evaluate the diagnostic performance of Contrast-Enhanced Ultrasonography (CEUS) using SonoVue as well as its medico-economic value for characterization of focal liver lesions. These nodules were not characterized on previous CT or conventional sonography. This prospective multicentric study conducted in 15 French centres found diagnostic performances similar to those reported for CT and MRI, with a concordance rate of 84.5%, sensitivity greater than 80% and specificity greater than 90% for all types of lesions. Higher acceptance was found for CEUS compared to other imaging modalities. Economical assessment based on examination reimbursment and contrast agent cost showed a lower cost for contrast ultrasound versus CT and MRI. This French multicentric study confirmed the high diagnostic value of CEUS for focal liver lesion characterization and demonstrated a lower economical impact compared to other imaging modalities such as CT and MRI.
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Affiliation(s)
- F Tranquart
- Pole Imagerie, CIC-IT Ultrasons-Radiopharmaceutiques, Hôpital Bretonneau, CHRU de Tours, UMR Inserm 930-CNRS 2448-Université François Rabelais, 37044 Tours Cedex 9, France.
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Benayoun M, Petrover D, Vilgrain V, Parlier-Cuau C, Bousson V, Bellaiche L, Laredo JD. [Medial foot pain in a marathon runner: a rare form of synostosis]. J Radiol 2009; 90:225-227. [PMID: 19308008 DOI: 10.1016/s0221-0363(09)72474-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Gaujoux S, Terris B, Bertherat J, Vilgrain V, Ruszniewski P, Dousset B. Massive postoperative ascites following pancreatic cysts fenestration in a patient with von Hippel-Lindau disease. Gastroenterol Clin Biol 2008; 32:910-913. [PMID: 18467057 DOI: 10.1016/j.gcb.2008.01.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Revised: 01/24/2008] [Accepted: 01/25/2008] [Indexed: 05/26/2023]
Abstract
Pancreatic lesions in von Hippel Lindau disease (VHLD) are frequent and mainly consist of cystic lesions, which should not be resected because of their benign evolution. Solid lesions, mostly pancreatic endocrine tumors (PET), are rare and usually occur in combination with cystic lesions. We report a case of a patient with VHLD who underwent PET enucleation in a polycystic pancreas requiring fenestration of multiple adjacent cysts, to ensure complete resection with free resection margins. The postoperative course was complicated by massive ascitic fluid effusion, probably related to pancreatic-cyst fenestration. Although this complication is well-known after liver-cyst fenestration, it has not been reported after pancreatic-cyst fenestration. This observation emphasizes that morbidity from surrounding pancreatic polycystic disease should not be underestimated in pancreatic surgery for VHLD.
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Affiliation(s)
- S Gaujoux
- Service de chirurgie digestive et endocrinienne, hôpital Cochin, AP-HP, université Paris-Descartes, Paris, France
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Tranquart F, Le Gouge A, Correas J, Ladam Marcus V, Manzoni P, Vilgrain V, Aube C, Bellin M, Chami L, Claudon M, Cuilleron M, Drouillard J, Gallix B, Lucidarme O, Marion D, Rode A, Tasu J, Trillaud H, Fayault A, Rusch E, Giraudeau B. Role of contrast-enhanced ultrasound in the blinded assessment of focal liver lesions in comparison with MDCT and CEMRI: Results from a multicentre clinical trial. EJC Suppl 2008. [DOI: 10.1016/j.ejcsup.2008.06.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Moucari R, Rautou PE, Cazals-Hatem D, Geara A, Bureau C, Consigny Y, Francoz C, Denninger MH, Vilgrain V, Belghiti J, Durand F, Valla D, Plessier A. Hepatocellular carcinoma in Budd-Chiari syndrome: characteristics and risk factors. Gut 2008; 57:828-35. [PMID: 18218675 DOI: 10.1136/gut.2007.139477] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS To analyse the characteristics of and the factors associated with the development of hepatocellular carcinoma (HCC) in patients with Budd-Chiari syndrome (BCS). PATIENTS AND METHODS 97 consecutive patients with BCS and a follow-up > or = 1 year were evaluated retrospectively. Liver nodules were evaluated using serum alpha-fetoprotein (AFP) level and imaging features (CT/MRI). Biopsy of nodules was obtained when one of the following criteria was met: number < or = 3, diameter > or = 3 cm, heterogeneity, washout on portal venous phase, increase in size on surveillance, or increase in AFP level. RESULTS Patients were mainly Caucasian (69%) and female (66%). Mean age at the diagnosis of BCS was 35.8 (SE 1.2 years), and median follow-up 5 years (1-20 years). The inferior vena cava (IVC) was obstructed in 13 patients. Liver nodules were found in 43 patients, 11 of whom had HCC. Cumulative incidence of HCC during follow-up was 4%. Liver parenchyma adjacent to HCC showed cirrhosis in nine patients. HCC was associated with male sex (72.7% v 29.0%, p = 0.007); factor V Leiden (54.5% v 17.5%, p = 0.01); and IVC obstruction (81.8% v 4.6%, p < 0.001). Increased levels of serum AFP were highly accurate in distinguishing HCC from benign nodules: PPV = 100% and NPV = 91% for a cut-off level of 15 ng/ml. CONCLUSION The incidence of HCC in this large cohort of BCS patients was similar to that reported for other chronic liver diseases. IVC obstruction was a major predictor for HCC development. Serum AFP appears to have a higher utility for HCC screening in patients with BCS than with other liver diseases.
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Affiliation(s)
- R Moucari
- AP-HP, Hôpital Beaujon, Service d'Hépatologie, Clichy, France
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Aussilhou B, Faivre S, Lepillé D, Le Tourneau C, Vilgrain V, Paradis V, Belghiti J. Preoperative bevacizumab may impair liver hypertrophy of the future remnant liver after a portal vein occlusion in patients undergoing major resections of colorectal liver metastasis. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Affiliation(s)
- M Lewin
- Département de radiologie, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
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