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Faure A, Dioguardi Burgio M, Cannella R, Sartoris R, Bouattour M, Hobeika C, Cauchy F, Trapani L, Beaufrère A, Vilgrain V, Ronot M. Imaging and prognostic characterization of fat-containing hepatocellular carcinoma subtypes. Radiol Med 2024; 129:687-701. [PMID: 38512627 DOI: 10.1007/s11547-024-01807-w] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Steatohepatitic hepatocellular carcinoma (SH-HCC) is characterized by intratumoral fat with > 50% inflammatory changes. However, intratumoral fat (with or without inflammation) can also be found in not-otherwise specified HCC (NOS-HCC). We compared the imaging features and outcome of resected HCC containing fat on pathology including SH-HCC (> 50% steatohepatitic component), NOS-HCC with < 50% steatohepatitic component (SH-NOS-HCC), and fatty NOS-HCC (no steatohepatitic component). MATERIAL AND METHODS From September 2012 to June 2021, 94 patients underwent hepatic resection for fat-containing HCC on pathology. Imaging features and categories were assessed using LIRADS v2018. Fat quantification was performed on chemical-shift MRI. Recurrence-free and overall survival were estimated. RESULTS Twenty-one patients (26%) had nonalcoholic steatohepatitis (NASH). The median intra-tumoral fat fraction was 8%, with differences between SH-HCC and SH-NOS-HCC (9.5% vs. 5% p = 0.03). There was no difference in major LI-RADS features between all groups; most tumors were classified as LR-4/5. A mosaic architecture on MRI was rare (7%) in SH-HCC, a fat in mass on CT was more frequently depicted (48%) in SH-HCC. A combination of NASH with no mosaic architecture on MRI or NASH with fat in mass on CT yielded excellent specificity for diagnosing SH-HCC (97.6% and 97.7%, respectively). The median recurrence-free and overall survival were 58 and 87 months, with no difference between groups (p = 0.18 and p = 0.69). CONCLUSION In patients with NASH, an SH-HCC may be suspected in L4/LR-5 observations with no mosaic architecture at MRI or with fat in mass on CT. Oncological outcomes appear similar between fat-containing HCC subtypes.
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Affiliation(s)
- Alexandre Faure
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
- UMR1149, Centre de Recherche Sur L'inflammation, Université Paris Cité, 75018, Paris, France.
| | - Roberto Cannella
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Riccardo Sartoris
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Mohamed Bouattour
- Department of Digestive Oncology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Christian Hobeika
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, AP-HP, 92110, Clichy, France
| | - Francois Cauchy
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, AP-HP, 92110, Clichy, France
| | - Loïc Trapani
- Department of Pathology, FHU MOSAIC, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Aurélie Beaufrère
- UMR1149, Centre de Recherche Sur L'inflammation, Université Paris Cité, 75018, Paris, France
- Department of Pathology, FHU MOSAIC, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France
- UMR1149, Centre de Recherche Sur L'inflammation, Université Paris Cité, 75018, Paris, France
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110, Clichy, France
- UMR1149, Centre de Recherche Sur L'inflammation, Université Paris Cité, 75018, Paris, France
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di Giuseppe R, Hansel B, Puyraimond Zemmour J, Vilgrain V, Ronot M, Garzelli L. Adding Short to Left Gastric Artery Embolization for the Treatment of Obesity: Safety and Effectiveness. Cardiovasc Intervent Radiol 2024:10.1007/s00270-024-03702-3. [PMID: 38653810 DOI: 10.1007/s00270-024-03702-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/28/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This study assessed the safety and effectiveness of a technical modification that involves adding short gastric artery (SGA) embolization to left gastric artery (LGA) embolization. MATERIAL AND METHODS This retrospective single-center study analyzed twenty obese patients (median age of 53.5 (30-73)) who were not eligible for bariatric surgery and underwent bariatric embolization with 300-500-µm microspheres in addition to a lifestyle counseling program between March 2021 and July 2022. Eight patients had LGA + SGA embolization, and twelve had LGA embolization alone. The primary outcome measure was total body weight loss (TBWL) at 6 months in the SGA + LGA and the LGA-only cohorts. Safety was assessed, defined as the 30-day adverse events rate according to the SIR classification. RESULTS The mean 6-month post-embolization TBWL in the SGA + LGA cohort was 7.3 kg (95%CI 2.1-12.4; p = .01) and 4.1 kg (95%CI 0.4-8.6; p = 0.034) in the LGA-only cohort (mean difference - 3.1 kg ± 2.8; 95%CI (- 9.1-2.8); p = .28). The mean 6-month post-embolization TBWL in the entire cohort was 5.3 kg (p < .01). The rate of complications was similar between the two groups. CONCLUSION Combined SGA and LGA embolization is safe and effective to treat obesity. Larger studies are needed to determine whether SGA + LGA embolization results in more significant weight loss than LGA embolization alone.
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Affiliation(s)
- Raphaël di Giuseppe
- Department of Radiology, Hôpital Beaujon, APHP.Nord, Université Paris Cité, Clichy, France
| | - Boris Hansel
- Department of Endocrinology-Diabetology-Nutrition, Hôpital Bichat, APHP.Nord, Université Paris Cité, Paris, France
| | - Jeremy Puyraimond Zemmour
- Department of Endocrinology-Diabetology-Nutrition, Hôpital Bichat, APHP.Nord, Université Paris Cité, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, APHP.Nord, Université Paris Cité, Clichy, France
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, APHP.Nord, Université Paris Cité, Clichy, France
| | - Lorenzo Garzelli
- Department of Radiology, Hôpital Beaujon, APHP.Nord, Université Paris Cité, Clichy, France.
- Department of Medical Imaging, Cayenne Hospital Centre, Cayenne, French Guiana.
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Hobeika C, Ronot M, Guiu B, Ferraioli G, Iijima H, Tada T, Lee DH, Kuroda H, Lee YH, Lee JM, Kim SY, Cassinotto C, Maiocchi L, Raimondi A, Nishimura T, Kumada T, Kwon EY, Jang JK, Correas JM, Valla D, Vilgrain V, Dioguardi Burgio M. Ultrasound-based steatosis grading system using 2D-attenuation imaging: an individual patient data meta-analysis with external validation. Hepatology 2024:01515467-990000000-00856. [PMID: 38652643 DOI: 10.1097/hep.0000000000000895] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/07/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND AND RATIONALE Non-invasive tools assessing steatosis, such as ultrasonography-based 2D-attenuation imaging (ATI), are needed to tackle the worldwide burden of steatotic liver disease. This one-stage individual patient data (IPD) meta-analysis aimed to create an ATI-based steatosis grading system. MAIN RESULTS A systematic review (EMBASE+MEDLINE, 2018-2022) identified studies, including patients with histologically or MRI-PDFF-verified ATI for grading steatosis (S0 to S3). One-stage IPD meta-analyses were conducted using generalized mixed models with a random study-specific intercept. Created ATI-based steatosis grading system (aS0 to aS3) was externally validated on a prospective cohort of patients with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD; n=174, histologically and MRI-PDFF verified steatosis). Eleven enrolled studies included 1374 patients, classified into S0, S1, S2, and S3 in 45.4%, 35.0%, 9.3%, and 10.3% of the cases. ATI was correlated with histological steatosis (r=0.60; 95%CI:0.52,0.67; p<0.001), and MRI-PDFF (r=0.70; 95%CI:0.66,0.73; p<0.001) but not with liver stiffness (r=0.03; 95%CI:-0.04,0.11, p=0.343). Steatosis grade was an independent factor associated with ATI (Coefficient: 0.24; 95%CI [0.22, 0.26]; p<0.001). ATI marginal means within S0, S1, S2, and S3 subpopulations were 0.59 (95%CI [0.58, 0.61]), 0.69 (95%CI [0.67, 0.71]), 0.78 95%CI [0.76, 0.81] and 0.85 95%CI [0.83, 0.88] dB/cm/MHz; all contrasts between grades significant (p<.0001). Three ATI thresholds were calibrated to create a new ATI-based steatosis grading system (aS0 to aS3, cut-offs: 0.66, 0.73, and 0.81 dB/cm/MHz). Its external validation showed Obuchowski measures of 0.84 ±0.02 and 0.82±0.02 with histologically- and MRI-PDFF-based references. CONCLUSIONS ATI is a reliable, non-invasive marker of steatosis. This validated ATI-based steatosis grading system could be valuable in assessing MASLD patients.
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Affiliation(s)
- Christian Hobeika
- Department of HPB Surgery and Liver Transplantation, AP-HP, Hôpital Beaujon, F-92110 Clichy, France
- Université Paris Cité, Inserm, CArcinose Péritoine Paris-Technologies, F-75010 Paris, France
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110 Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018 Paris, France
| | - Boris Guiu
- Department of Radiology, St-Eloi University Hospital, 80 avenue Augustin Fliche, 34295, Montpellier, France
| | - Giovanna Ferraioli
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, Viale Brambilla 74, 27100 Pavia, Italy
| | - Hiroko Iijima
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Hyogo, Japan
| | - Toshifumi Tada
- Department of Internal medicine, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Hidekatsu Kuroda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Young Hwan Lee
- Department of Radiology, Wonkwang University School of Medicine and Hospital, Iksan, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080, Korea
| | - So Yeon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Christophe Cassinotto
- Department of Radiology, St-Eloi University Hospital, 80 avenue Augustin Fliche, 34295, Montpellier, France
| | - Laura Maiocchi
- Ultrasound Unit, Dipartimento Servizi Diagnostici e per Immagini Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Ambra Raimondi
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, University of Pavia, Viale Brambilla 74, 27100 Pavia, Italy
- Ultrasound Unit, Dipartimento Servizi Diagnostici e per Immagini Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Takashi Nishimura
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo Medical University, Hyogo, Japan
| | - Takashi Kumada
- Department of Nursing, Gifu Kyoritsu University, Gifu, Japan
| | - Eun Young Kwon
- Department of Radiology, Wonkwang University School of Medicine and Hospital, Iksan, Korea
| | - Jong Keon Jang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jean-Michel Correas
- AP-HP, Hôpital Necker Enfants Malades, Service d'Imagerie Adulte, F-75015 Paris, France
- Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, F-75005 Paris, France
| | - Dominique Valla
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018 Paris, France
- Service d'hépatologie, Hôpital Beaujon, 92110 Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110 Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018 Paris, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 100 Boulevard du Général Leclerc, 92110 Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018 Paris, France
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Pastor CM, Vilgrain V. New understanding of hepatobiliary MRI. Nat Rev Gastroenterol Hepatol 2024:10.1038/s41575-024-00926-z. [PMID: 38565648 DOI: 10.1038/s41575-024-00926-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Catherine M Pastor
- Université Paris-Cité, Paris, France.
- Centre de Recherche sur l'Inflammation, INSERM 1149, Paris, France.
| | - Valérie Vilgrain
- Université Paris-Cité, Paris, France
- Centre de Recherche sur l'Inflammation, INSERM 1149, Paris, France
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Grégory J, Ronot M, Laurent V, Chabrot P, de Baere T, Chevallier P, Vilgrain V, Aubé C. French Interventional Radiology Centers' Uptake of Transradial Approach and Outpatient Hepatocellular Carcinoma Intra-Arterial Treatments. Cardiovasc Intervent Radiol 2024; 47:432-440. [PMID: 37930400 DOI: 10.1007/s00270-023-03578-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/01/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE This study aims to investigate the uptake of transradial approach (TRA) and outpatient setting for transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) in the treatment of hepatocellular carcinoma (HCC) among French interventional radiology centers. MATERIALS AND METHODS This cross-sectional study was based on a 34-question survey assessing center activity, radial access, and outpatient care. The survey was developed by a working group, tested by two external experts, and distributed to active members of two French radiological societies via a web-based self-reporting questionnaire in March 2022. The survey remained open for eight weeks, with two reminder emails sent to non-responders. Only one answer per center was considered. RESULTS Of the 44 responding centers, 39% (17/44) performed TRA for TACE and/or TARE, with post-procedure patient comfort as main motivation. Among the 27 centers not performing TRA, 33% (9/27) reported a lack of technical experience, but all 27 intended to adopt TRA within two years. Only six centers performed TACE or TARE in an outpatient setting. Reasons limiting its implementation included TACE for HCC not being a suitable intervention (61%, 27/44) and organizational barriers (41%, 18/44). Among centers not performing outpatient TACE or TARE, 34% (13/38) said "No," 34% (13/38) said "Maybe," and 32% (12/38) said "Yes" when asked about adopting it within two years. CONCLUSION French interventional radiologists have low TRA uptake for HCC treatment, but TRA adoption potential exists. Respondents were uncertain about performing TACE or TARE in an outpatient setting within a 2-year horizon.
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Affiliation(s)
- Jules Grégory
- Université Paris Cité, Paris, France.
- Radiology Department, Hôpital Beaujon, AP-HP.Nord, FHU MOSAIC, 100 boulevard du Général Leclerc, 92210, Clichy, France.
- Inserm INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004, Paris, France.
| | - Maxime Ronot
- Université Paris Cité, Paris, France
- Radiology Department, Hôpital Beaujon, AP-HP.Nord, FHU MOSAIC, 100 boulevard du Général Leclerc, 92210, Clichy, France
- Centre de Recherche sur L'Inflammation, Inserm, U1149, 75006, Paris, France
| | - Valérie Laurent
- Department of Radiology, Nancy University Hospital, Université de Lorraine, 54500, Vandoeuvre-Lès-Nancy, France
| | - Pascal Chabrot
- Department of Radiology, University Hospital Center, Hospital Gabriel Montpied, 58, Rue Montalembert, 63000, Clermont-Ferrand, France
| | - Thierry de Baere
- Department of Interventional Radiology, Gustave RoussyUniversité Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Patrick Chevallier
- Department of Diagnosis and Interventional Imaging, University Hospital of Nice, 151 Route de Saint Antoine de Ginestière, 06200, Nice, France
| | - Valérie Vilgrain
- Université Paris Cité, Paris, France
- Radiology Department, Hôpital Beaujon, AP-HP.Nord, FHU MOSAIC, 100 boulevard du Général Leclerc, 92210, Clichy, France
- Centre de Recherche sur L'Inflammation, Inserm, U1149, 75006, Paris, France
| | - Christophe Aubé
- Département de Radiologie, centre hospitalier universitaire d'Angers, 4 rue Larrey, 49 933, Angers, France
- Laboratoire HIFIH, UPRES 3859, Université d'Angers, 49 045, Angers, France
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Delagnes A, Roux M, Vilgrain V, Guiu B, Laurent V, Sutter O, Bricault I, Trillaud H, Aubé C, Paisant A. Fat-containing hepatocellular carcinoma in patients with cirrhosis: proposal of a diagnostic modification regarding enhancement characteristics. Eur Radiol 2024; 34:2283-2293. [PMID: 37816923 DOI: 10.1007/s00330-023-10236-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES The aim of this study was to develop and validate an algorithm for the non-invasive diagnosis of these fat-containing HCCs. METHODS Eighty-four cirrhotic patients with 77 fat-containing HCCs and 11 non-HCC fat-containing nodules were retrospectively included. All MRIs were reviewed; nodule characteristics, European Association for the Study of the Liver (EASL) and LI-RADS classifications, and survival were collected. One of the major features of LI-RADS v2018 (non-rim-like arterial phase hyperenhancement [APHE]) was changed to include different enhancing patterns at arterial phase and a new fat-LI-RADS algorithm was created for fat-containing nodules in cirrhosis. Its diagnostic performance was evaluated in both a derivation and external validation cohort (external cohort including 58 fat-containing HCCs and 10 non-HCC fat nodules). Reproducibility of this new algorithm was assessed. RESULTS In the derivation cohort, 54/77 (70.1%) fat-containing HCCs had APHE, 62/77 (80.5%) had enhancement compared to the nodule itself at arterial phase (APE), 43/77 (55.8%) had washout, and 20/77 (26.0%) had an enhancing capsule. EASL and LI-RADS had a sensitivity of 37.7% (29/77) and 36.4% (28/77), respectively, for the diagnosis of fat-containing HCC and both had a specificity of 100% (11/11). The new fat-LI-RADS algorithm increased sensitivity to 50.6% (39/77) without decreasing the specificity of 100% (11/11). The validation cohort confirmed the increased sensitivity, with a slight decrease in specificity. The concordance for the diagnosis of HCC for fat-LR5 was 85.3% (58/68). CONCLUSION The new fat-LI-RADS algorithm proposed here significantly improves the performance of the non-invasive diagnosis of fat-containing HCC and thus could reduce the number of biopsies conducted for fat-containing HCCs. CLINICAL RELEVANCE STATEMENT The European Association for the Study of the Liver and LI-RADS guidelines are poorly sensitive for the diagnosis of fat-containing HCC, mainly because of the low rate of arterial phase hyperenhancement (APHE) displayed by fat-containing HCC. Using all types of enhancement instead of APHE improves sensitivity of LI-RADS. KEY POINTS • Fat-containing HCCs on MRI account for 7.5% of HCCs and have different imaging characteristics from non-fatty HCCs. • The European Association for the Study of the Liver and LI-RADS algorithms for the non-invasive diagnosis of HCC have low sensitivity for the diagnosis of fat-containing HCC with MRI (37.7% and 36.4%, respectively). • The new fat-LI-RADS, which includes a slight modification of the "arterial enhancement" criterion, improves the sensitivity for the diagnosis of fat-containing HCC using MRI, without degrading the specificity.
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Affiliation(s)
- Anaïs Delagnes
- Department of Radiology, Angers University Hospital, 4 Rue Larrey, 49933, Angers, France.
| | - Marine Roux
- HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Valérie Vilgrain
- Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
- INSERM U1149, CRI, University Paris Diderot, Paris, France
| | - Boris Guiu
- Department of Radiology, Saint-Eloi Hospital, University Hospital of Montpellier, Montpellier, France
| | - Valérie Laurent
- Department of Radiology, Nancy University Hospital, Lorraine University, 54500, Vandœuvre-Lès-Nancy, France
| | - Olivier Sutter
- Department of Radiology, Avicenne Hospital, Paris-Seine-Saint-Denis University Hospitals, Assistance-Publique Hôpitaux de Paris, 93000, Bobigny, France
| | - Ivan Bricault
- Laboratory of Techniques for Biomedical Engineering and Complexity Management, University Grenoble Alpes, National Center for Scientific Research, Grenoble, France
- Department of Radiology and Medical Imaging, University Hospital, Grenoble, La Tronche, France
| | - Hervé Trillaud
- Department of Diagnostic and Interventional Radiology, University Hospital Bordeaux, 33600, Pessac, France
- EA Imotion, University of Bordeaux, 33076, Bordeaux, France
| | - Christophe Aubé
- Department of Radiology, Angers University Hospital, 4 Rue Larrey, 49933, Angers, France
- HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Anita Paisant
- Department of Radiology, Angers University Hospital, 4 Rue Larrey, 49933, Angers, France
- HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
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Grégory J, Ronot M, Laurent V, Chabrot P, de Baere T, Chevallier P, Vilgrain V, Aubé C. Correction to: French Interventional Radiology Centers' Uptake of Transradial Approach and Outpatient Hepatocellular Carcinoma Intra-arterial Treatments. Cardiovasc Intervent Radiol 2024; 47:531. [PMID: 38491166 DOI: 10.1007/s00270-024-03698-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Affiliation(s)
- Jules Grégory
- Université Paris Cité, Paris, France.
- Radiology Department, Hôpital Beaujon, AP-HP.Nord, FHU MOSAIC, 100 boulevard du Général Leclerc, 92210, Clichy, France.
- Inserm INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004, Paris, France.
| | - Maxime Ronot
- Université Paris Cité, Paris, France
- Radiology Department, Hôpital Beaujon, AP-HP.Nord, FHU MOSAIC, 100 boulevard du Général Leclerc, 92210, Clichy, France
- Centre de Recherche sur L'Inflammation, Inserm, U1149, 75006, Paris, France
| | - Valérie Laurent
- Department of Radiology, Nancy University Hospital, Université de Lorraine, 54500, Vandoeuvre-Lès-Nancy, France
| | - Pascal Chabrot
- Department of Radiology, University Hospital Center, Hospital Gabriel Montpied, 58, Rue Montalembert, 63000, Clermont-Ferrand, France
| | - Thierry de Baere
- Department of Interventional Radiology, Gustave RoussyUniversité Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Patrick Chevallier
- Department of Diagnosis and Interventional Imaging, University Hospital of Nice, 151 Route de Saint Antoine de Ginestière, 06200, Nice, France
| | - Valérie Vilgrain
- Université Paris Cité, Paris, France
- Radiology Department, Hôpital Beaujon, AP-HP.Nord, FHU MOSAIC, 100 boulevard du Général Leclerc, 92210, Clichy, France
- Centre de Recherche sur L'Inflammation, Inserm, U1149, 75006, Paris, France
| | - Christophe Aubé
- Département de Radiologie, centre hospitalier universitaire d'Angers, 4 rue Larrey, 49 933, Angers, France
- Laboratoire HIFIH, UPRES 3859, Université d'Angers, 49 045, Angers, France
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Bouattour M, Vilgrain V, Sepulveda A. ESR Bridges: imaging and treatment of hepatocellular carcinoma-a multidisciplinary view. Eur Radiol 2024:10.1007/s00330-023-10579-2. [PMID: 38488966 DOI: 10.1007/s00330-023-10579-2] [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: 12/19/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 03/17/2024]
Affiliation(s)
- Mohamed Bouattour
- AP-HP, Liver Cancer and Innovative Therapy Unit, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
- Centre de Recherche Sur L'Inflammation (CRI), INSERM, U1149, CNRS, ERL 8252, F-75018, Paris, France.
| | - Valérie Vilgrain
- Centre de Recherche Sur L'Inflammation (CRI), INSERM, U1149, CNRS, ERL 8252, F-75018, Paris, France
- AP-HP, Department Radiology, Beaujon Hospital, Clichy, France
| | - Ailton Sepulveda
- AP-HP, Department of HPB Surgery & Liver Transplantation, Beaujon Hospital, Clichy, France
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Chauhan A, Choi JY, Stoker J, Vilgrain V. The Global Reading Room: An Indeterminate Liver Lesion. AJR Am J Roentgenol 2024. [PMID: 38447021 DOI: 10.2214/ajr.24.31091] [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] [Indexed: 03/08/2024]
Affiliation(s)
- Anil Chauhan
- Department of Radiology, University of Kansas Medical Center, Kansas City, Kansas United States
| | - Jin-Young Choi
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jaap Stoker
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - Valérie Vilgrain
- Hôpital Beaujon, APHP.Nord, Université Paris Cité, Paris, France
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Reimer P, Vilgrain V, Arnold D, Balli T, Golfieri R, Loffroy R, Mosconi C, Ronot M, Sengel C, Schaefer N, Maleux G, Munneke G, Peynircioglu B, Sangro B, Kaufmann N, Urdaniz M, Pereira H, de Jong N, Helmberger T. Factors Impacting Survival After Transarterial Radioembolization in Patients with Unresectable Intrahepatic Cholangiocarcinoma: A Combined Analysis of the Prospective CIRT Studies. Cardiovasc Intervent Radiol 2024; 47:310-324. [PMID: 38321223 PMCID: PMC10920466 DOI: 10.1007/s00270-023-03657-x] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/27/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is a treatment option for patients with intrahepatic cholangiocarcinoma (ICC). However, optimising the timing of TARE in relation to systemic therapies and patient selection remains challenging. We report here on the effectiveness, safety, and prognostic factors associated with TARE for ICC in a combined analysis of the prospective observational CIRT studies (NCT02305459 and NCT03256994). METHODS A combined analysis of 174 unresectable ICC patients enrolled between 2015 and 2020 was performed. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival [OS], progression-free survival [PFS] and hepatic PFS) were collected at every follow-up visit. Log-rank tests and a multivariable Cox proportional hazard model were used to identify prognostic factors. RESULTS Patients receiving a first-line strategy of TARE in addition to any systemic treatment had a median OS and PFS of 32.5 months and 11.3 months. Patients selected for first-line TARE alone showed a median OS and PFS of 16.2 months and 7.4 months, whereas TARE as 2nd or further treatment-line resulted in a median OS and PFS of 12 and 9.3 months (p = 0.0028), and 5.1 and 3.5 months (p = 0.0012), respectively. Partition model dosimetry was an independent predictor for better OS (HR 0.59 [95% CI 0.37-0.94], p = 0.0259). No extrahepatic disease, no ascites, and < 6.1 months from diagnosis to treatment were independent predictors for longer PFS. CONCLUSION This combined analysis indicates that in unresectable ICC, TARE in combination with any systemic treatment is a promising treatment option. LEVEL OF EVIDENCE level 3, Prospective observational.
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Affiliation(s)
- Peter Reimer
- Städtisches Klinikum Karlsruhe, Institute for Diagnostic and Interventional Radiology, Academic Teaching Hospital the University of Freiburg, Moltkestraße 90, 76133, Karlsruhe, Germany
| | - Valérie Vilgrain
- Université Paris Cité, CRI, INSERM, 1149, Paris, France
- Department of Radiology, Hôpital Beaujon APHP Nord, Clichy, France
| | - Dirk Arnold
- Oncology and Hematology, Asklepios Tumorzentrum Hamburg, AK Altona, Paul-Ehrlich-Str. 1, 22763, Hamburg, Germany
| | - Tugsan Balli
- Radiology Department, Çukurova University, Balcalı Hospital, 01330, Adana, Turkey
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, CHU Dijon Bourgogne, François-Mitterrand University Hospital, 14 Rue Gaffarel, 21000, Dijon, France
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Maxime Ronot
- Université Paris Cité, CRI, INSERM, 1149, Paris, France
- Department of Radiology, Hôpital Beaujon APHP Nord, Clichy, France
| | - Christian Sengel
- Interventional Radiology, Centre Hospitalier Universitaire de Grenoble, Boulevard de La Chantourne, 38100, Grenoble, France
| | - Niklaus Schaefer
- Service de Médecine Nucléaire Et Imagerie Moléculaire, CHUV, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Geert Maleux
- Radiology, Universitair Ziekenhuis Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Graham Munneke
- Interventional Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK
| | - Bora Peynircioglu
- Department of Radiology, School of Medicine, Hacettepe University, Sihhiye Campus, 06100, Ankara, Turkey
| | - Bruno Sangro
- Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and CIBEREHD, Avda. Pio XII 36, 31008, Pamplona, Spain
| | - Nathalie Kaufmann
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Neutorgasse 9, 1010, Vienna, Austria
| | - Maria Urdaniz
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Neutorgasse 9, 1010, Vienna, Austria
| | - Helena Pereira
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Unité de Recherche Clinique, Paris, France
- INSERM, Centre d'Investigation Clinique 1418 (CIC1418), Paris, France
| | - Niels de Jong
- Clinical Research Department, Cardiovascular and Interventional Radiological Society of Europe, Neutorgasse 9, 1010, Vienna, Austria.
| | - Thomas Helmberger
- Department of Radiology, Neuroradiology and Minimal-Invasive Therapy, Klinikum Bogenhausen, Englschalkinger Str. 77, 81925, Munich, Germany
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Nachit M, Dioguardi Burgio M, Abyzov A, Garteiser P, Paradis V, Vilgrain V, Leclercq I, Van Beers BE. Hepatocellular carcinoma in patients with non-alcoholic fatty liver disease is associated with heterogeneous pattern of fat infiltration in skeletal muscles. Eur Radiol 2024; 34:1461-1470. [PMID: 37658893 DOI: 10.1007/s00330-023-10131-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/20/2023] [Accepted: 07/04/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES To evaluate the association between fat infiltration in skeletal muscles (myosteatosis) and hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). METHODS In a cross-sectional cohort of 72 histologically proven NAFLD patients (n = 38 with non-alcoholic steatohepatitis; NASH), among which 20 had HCC diagnosed on biopsy, we used proton density fat fraction (PDFF) at MRI to evaluate myosteatosis in skeletal muscles (mean fat fraction and first order radiomic-based pattern) at the third lumbar level, namely in erector spinae (ES), quadratus lumborum (QL), psoas, oblique, and rectus muscles. RESULTS PDFFES was 70% higher in patients with HCC when compared to those without HCC (9.6 ± 5.5% versus 5.7 ± 3.0%, respectively, p < 0.001). In multivariate logistic regression, PDFFES was a significant predictor of the presence of HCC (AUC = 0.72, 95% CI 0.57-0.86, p = 0.002) independently from age, sex, visceral fat area, and liver fibrosis stage (all p < 0.05). The relationship between PDFFES and HCC was exacerbated in patients with NASH (AUC = 0.79, 95% CI 0.63-0.86, p = 0.006). In patients with NASH, radiomics features of heterogeneity such as energy and entropy in any of the paraspinal muscles (i.e., ES, QL, or psoas) were independent predictors of HCC. EnergyES identified patients with HCC (n = 13) in the NASH population with AUC = 0.92 (95% CI 0.82-1.00, p < 0.001). CONCLUSION In patients with NAFLD, and more specifically in those with NASH, the degree and heterogeneity of myosteatosis is independently associated with HCC irrespective of liver fibrosis stage. CLINICAL RELEVANCE STATEMENT Our data suggest that myosteatosis could be used as a biomarker of HCC in the ever-expanding NAFLD population and pave the way for further investigation in longitudinal studies. KEY POINTS • HCC in patients with non-alcoholic fatty liver disease, and more specifically in those with non-alcoholic steatohepatitis, is independently associated with severe fatty infiltration (myosteatosis) of paravertebral skeletal muscles. • Association between myosteatosis and HCC is independent from liver fibrosis stage. • Histogram-based radiomics features of myosteatosis predicts the risk of HCC in patients with non-alcoholic steatohepatitis.
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Affiliation(s)
- Maxime Nachit
- Laboratory of Hepato-Gastroenterology, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium.
- Department of Imaging and Pathology, KU Leuven, Louvain, Belgium.
| | - Marco Dioguardi Burgio
- Laboratory of Imaging Biomarkers, Center of Research On Inflammation, Université Paris Cité, Inserm, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, AP-HP, Clichy, France
| | - Anton Abyzov
- Laboratory of Imaging Biomarkers, Center of Research On Inflammation, Université Paris Cité, Inserm, Paris, France
| | - Philippe Garteiser
- Laboratory of Imaging Biomarkers, Center of Research On Inflammation, Université Paris Cité, Inserm, Paris, France
| | - Valérie Paradis
- Team "From Inflammation to Cancer in Digestive Disease", Center of Research on Inflammation, Université Paris Cité, Inserm, Paris, France
- Department of Pathology, Beaujon University Hospital Paris Nord, AP-HP, Clichy, France
| | - Valérie Vilgrain
- Laboratory of Imaging Biomarkers, Center of Research On Inflammation, Université Paris Cité, Inserm, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, AP-HP, Clichy, France
| | - Isabelle Leclercq
- Laboratory of Hepato-Gastroenterology, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium
| | - Bernard E Van Beers
- Laboratory of Imaging Biomarkers, Center of Research On Inflammation, Université Paris Cité, Inserm, Paris, France
- Department of Radiology, Beaujon University Hospital Paris Nord, AP-HP, Clichy, France
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Porrello G, Cannella R, Bernuau J, Agman A, Brancatelli G, Dioguardi Burgio M, Vilgrain V. Liver imaging and pregnancy: what to expect when your patient is expecting. Insights Imaging 2024; 15:66. [PMID: 38411871 PMCID: PMC10899155 DOI: 10.1186/s13244-024-01622-x] [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: 06/08/2023] [Accepted: 01/07/2024] [Indexed: 02/28/2024] Open
Abstract
Liver diseases in pregnancy can be specific to gestation or only coincidental. In the latter case, the diagnosis can be difficult. Rapid diagnosis of maternal-fetal emergencies and situations requiring specialized interventions are crucial to preserve the maternal liver and guarantee materno-fetal survival. While detailed questioning of the patient and a clinical examination are highly important, imaging is often essential to reach a diagnosis of these liver diseases and lesions. Three groups of liver diseases may be observed during pregnancy: (1) diseases related to pregnancy: intrahepatic cholestasis of pregnancy, pre-eclampsia, eclampsia, hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, and acute fatty liver of pregnancy; (2) liver diseases that are more frequent during or exacerbated by pregnancy: acute herpes simplex hepatitis, Budd-Chiari syndrome, hemorrhagic hereditary telangiectasia, hepatocellular adenoma, portal vein thrombosis, and cholelithiasis; (3) coincidental conditions, including acute hepatitis, incidental focal liver lesions, metabolic dysfunction-associated steatotic liver disease, cirrhosis, hepatocellular carcinoma, liver abscesses and parasitosis, and liver transplantation. Specific knowledge of the main imaging findings is required to reach an early diagnosis, for adequate follow-up, and to avoid adverse consequences in both the mother and the fetus.Critical relevance statement Pregnancy-related liver diseases are the most important cause of liver dysfunction in pregnant patients and, in pregnancy, even common liver conditions can have an unexpected turn. Fear of radiations should never delay necessary imaging studies in pregnancy.Key points• Pregnancy-related liver diseases are the most frequent cause of liver dysfunction during gestation.• Fear of radiation should never delay necessary imaging studies.• Liver imaging is important to assess liver emergencies and for the diagnosis and follow-up of any other liver diseases.• Common liver conditions and lesions may take an unexpected turn during pregnancy.• Pregnancy-specific diseases such as pre-eclampsia and HELLP syndrome must be rapidly identified. However, imaging should never delay delivery when it is considered to be urgent for maternal-fetal survival.
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Affiliation(s)
- Giorgia Porrello
- Service de Radiologie, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France.
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University Hospital "Paolo Giaccone", Palermo, Italy.
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University Hospital "Paolo Giaccone", Palermo, Italy
| | - Jacques Bernuau
- AP-HP Nord, Hôpital Beaujon, Service d'Hépatologie, Paris, Clichy, France
| | - Antoine Agman
- Service de Gynécologie obstétrique maternité, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France
| | - Giuseppe Brancatelli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University Hospital "Paolo Giaccone", Palermo, Italy
| | - Marco Dioguardi Burgio
- Service de Radiologie, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018, Paris, France
| | - Valérie Vilgrain
- Service de Radiologie, AP-HP Nord, Hôpital Beaujon, Paris, Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018, Paris, France
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Cannella R, Matteini F, Dioguardi Burgio M, Sartoris R, Beaufrère A, Calderaro J, Mulé S, Reizine E, Luciani A, Laurent A, Seror O, Ganne-Carrié N, Wagner M, Scatton O, Vilgrain V, Cauchy F, Hobeika C, Ronot M. Association of LI-RADS and Histopathologic Features with Survival in Patients with Solitary Resected Hepatocellular Carcinoma. Radiology 2024; 310:e231160. [PMID: 38411519 DOI: 10.1148/radiol.231160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/28/2024]
Abstract
Background Both Liver Imaging Reporting and Data System (LI-RADS) and histopathologic features provide prognostic information in patients with hepatocellular carcinoma (HCC), but whether LI-RADS is independently associated with survival is uncertain. Purpose To assess the association of LI-RADS categories and features with survival outcomes in patients with solitary resected HCC. Materials and Methods This retrospective study included patients with solitary resected HCC from three institutions examined with preoperative contrast-enhanced CT and/or MRI between January 2008 and December 2019. Three independent readers evaluated the LI-RADS version 2018 categories and features. Histopathologic features including World Health Organization tumor grade, microvascular and macrovascular invasion, satellite nodules, and tumor capsule were recorded. Overall survival and disease-free survival were assessed with Cox regression models. Marginal effects of nontargetoid features on survival were estimated using propensity score matching. Results A total of 360 patients (median age, 64 years [IQR, 56-70 years]; 280 male patients) were included. At CT and MRI, the LI-RADS LR-M category was associated with increased risk of recurrence (CT: hazard ratio [HR] = 1.83 [95% CI: 1.26, 2.66], P = .001; MRI: HR = 2.22 [95% CI: 1.56, 3.16], P < .001) and death (CT: HR = 2.47 [95% CI: 1.72, 3.55], P < .001; MRI: HR = 1.80 [95% CI: 1.32, 2.46], P < .001) independently of histopathologic features. The presence of at least one nontargetoid feature was associated with an increased risk of recurrence (CT: HR = 1.80 [95% CI: 1.36, 2.38], P < .001; MRI: HR = 1.93 [95% CI: 1.81, 2.06], P < .001) and death (CT: HR = 1.51 [95% CI: 1.10, 2.07], P < .010) independently of histopathologic features. In matched samples, recurrence was associated with the presence of at least one nontargetoid feature at CT (HR = 2.06 [95% CI: 1.15, 3.66]; P = .02) or MRI (HR = 1.79 [95% CI: 1.01, 3.20]; P = .048). Conclusion In patients with solitary resected HCC, LR-M category and nontargetoid features were negatively associated with survival independently of histopathologic characteristics. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Kartalis and Grigoriadis in this issue.
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Affiliation(s)
- Roberto Cannella
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Francesco Matteini
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Marco Dioguardi Burgio
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Riccardo Sartoris
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Aurélie Beaufrère
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Julien Calderaro
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Sébastien Mulé
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Edouard Reizine
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Alain Luciani
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Alexis Laurent
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Olivier Seror
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Nathalie Ganne-Carrié
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Mathilde Wagner
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Olivier Scatton
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Valérie Vilgrain
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - François Cauchy
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Christian Hobeika
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
| | - Maxime Ronot
- From the Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy (R.C., F.M.); Departments of Radiology (F.M., M.D.B., R.S., V.V., M.R.), Pathology (A.B.), and Hepatobiliary Surgery (F.C., C.H.), Hôpital Beaujon, AP-HP Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France; Université Paris Cité, Paris, France (A.B., V.V., M.R.); Centre de Recherche sur l'Inflammation, INSERM UMR 1149, Paris, France (A.B.); Departments of Pathology (J.C.), Medical Imaging (S.M., E.R., A. Luciani), and Hepatobiliary and Digestive Surgery (A. Laurent), Hôpitaux Universitaires Henri-Mondor, AP-HP, Université Paris Est Créteil, Faculté de Santé, Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," Créteil, France (A. Laurent); Department of Radiology (O. Seror) and Liver Unit (N.G.C.), Avicenne Hospital, AP-HP, Bobigny, France; Sorbonne Paris Nord University, UFR SMBH, Bobigny, France (N.G.C.); INSERM UMR 1138, Team "Functional Genomic of Solid Tumors," Paris, France (N.G.C.); and Departments of Imaging (M.W.) and HPB and Liver Transplantation (O. Scatton), Hôpital Universitaire Pitié-Salpêtrière, AP-HP, Sorbonne Université, Centre de Recherche Saint-Antoine INSERM, Paris, France
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14
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Nachef C, Bousson V, Belmatoug N, Cohen-Solal M, Vilgrain V, Roux O, Francoz C, Durand F, Funck-Brentano T. Osteoporosis and Fragility Fractures in Patients With Cirrhosis Evaluated for Liver Transplantation: Identification of High-Risk Patients Based on Computed Tomography at Evaluation. Am J Gastroenterol 2024; 119:367-370. [PMID: 37734343 DOI: 10.14309/ajg.0000000000002507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/04/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION Osteoporosis in candidates for liver transplantation (LT) is often underdiagnosed despite the important consequences of morbidity. METHODS We included 376 patients with cirrhosis evaluated for LT with available computed tomography (CT) scans. Prevalent vertebral fractures (VFs) were identified on CT reconstructions, and bone density was assessed by measuring CT attenuation of the L1 vertebra (L1-CT). RESULTS We identified 139 VFs in 55 patients (14.6%). Logistic regression models showed that low L1-CT was the only independent determinant of VF. DISCUSSION In patients with cirrhosis evaluated for LT, CT scans identified persons with severe osteoporosis without additional costs.
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Affiliation(s)
- Clément Nachef
- Department of Rheumatology, Lariboisière Hospital, APHP.Nord, Université Paris Cité, Paris, France
- Bioscar INSERM U1132, Université de Paris, Paris, France
| | - Valérie Bousson
- Department of Radiology, Lariboisière Hospital, APHP.Nord, Université Paris Cité, Paris, France
| | - Nadia Belmatoug
- Department of Internal Medicine, Beaujon Hospital, APHP.Nord, Université de Paris, Paris, France
| | - Martine Cohen-Solal
- Department of Rheumatology, Lariboisière Hospital, APHP.Nord, Université Paris Cité, Paris, France
- Bioscar INSERM U1132, Université de Paris, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Beaujon Hospital, APHP.Nord, Université Paris Cité, Paris, France
| | - Olivier Roux
- Department of Hepatology & Liver Intensive Care, Beaujon Hospital, APHP.Nord, Université Paris Cité, Paris, France
| | - Claire Francoz
- Department of Hepatology & Liver Intensive Care, Beaujon Hospital, APHP.Nord, Université Paris Cité, Paris, France
| | - François Durand
- Department of Hepatology & Liver Intensive Care, Beaujon Hospital, APHP.Nord, Université Paris Cité, Paris, France
| | - Thomas Funck-Brentano
- Department of Rheumatology, Lariboisière Hospital, APHP.Nord, Université Paris Cité, Paris, France
- Bioscar INSERM U1132, Université de Paris, Paris, France
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15
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Gross M, Huber S, Arora S, Ze'evi T, Haider SP, Kucukkaya AS, Iseke S, Kuhn TN, Gebauer B, Michallek F, Dewey M, Vilgrain V, Sartoris R, Ronot M, Jaffe A, Strazzabosco M, Chapiro J, Onofrey JA. Automated MRI liver segmentation for anatomical segmentation, liver volumetry, and the extraction of radiomics. Eur Radiol 2024:10.1007/s00330-023-10495-5. [PMID: 38217704 DOI: 10.1007/s00330-023-10495-5] [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: 08/22/2023] [Revised: 09/20/2023] [Accepted: 10/29/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES To develop and evaluate a deep convolutional neural network (DCNN) for automated liver segmentation, volumetry, and radiomic feature extraction on contrast-enhanced portal venous phase magnetic resonance imaging (MRI). MATERIALS AND METHODS This retrospective study included hepatocellular carcinoma patients from an institutional database with portal venous MRI. After manual segmentation, the data was randomly split into independent training, validation, and internal testing sets. From a collaborating institution, de-identified scans were used for external testing. The public LiverHccSeg dataset was used for further external validation. A 3D DCNN was trained to automatically segment the liver. Segmentation accuracy was quantified by the Dice similarity coefficient (DSC) with respect to manual segmentation. A Mann-Whitney U test was used to compare the internal and external test sets. Agreement of volumetry and radiomic features was assessed using the intraclass correlation coefficient (ICC). RESULTS In total, 470 patients met the inclusion criteria (63.9±8.2 years; 376 males) and 20 patients were used for external validation (41±12 years; 13 males). DSC segmentation accuracy of the DCNN was similarly high between the internal (0.97±0.01) and external (0.96±0.03) test sets (p=0.28) and demonstrated robust segmentation performance on public testing (0.93±0.03). Agreement of liver volumetry was satisfactory in the internal (ICC, 0.99), external (ICC, 0.97), and public (ICC, 0.85) test sets. Radiomic features demonstrated excellent agreement in the internal (mean ICC, 0.98±0.04), external (mean ICC, 0.94±0.10), and public (mean ICC, 0.91±0.09) datasets. CONCLUSION Automated liver segmentation yields robust and generalizable segmentation performance on MRI data and can be used for volumetry and radiomic feature extraction. CLINICAL RELEVANCE STATEMENT Liver volumetry, anatomic localization, and extraction of quantitative imaging biomarkers require accurate segmentation, but manual segmentation is time-consuming. A deep convolutional neural network demonstrates fast and accurate segmentation performance on T1-weighted portal venous MRI. KEY POINTS • This deep convolutional neural network yields robust and generalizable liver segmentation performance on internal, external, and public testing data. • Automated liver volumetry demonstrated excellent agreement with manual volumetry. • Automated liver segmentations can be used for robust and reproducible radiomic feature extraction.
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Affiliation(s)
- Moritz Gross
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.
- Charité Center for Diagnostic and Interventional Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Steffen Huber
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Sandeep Arora
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Tal Ze'evi
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Stefan P Haider
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
- Department of Otorhinolaryngology, University Hospital of Ludwig Maximilians Universität München, Munich, Germany
| | - Ahmet S Kucukkaya
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
- Charité Center for Diagnostic and Interventional Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Simon Iseke
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
- Department of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Tom Niklas Kuhn
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
- Department of Diagnostic and Interventional Radiology, University Duesseldorf, Duesseldorf, Germany
| | - Bernhard Gebauer
- Charité Center for Diagnostic and Interventional Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Michallek
- Charité Center for Diagnostic and Interventional Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Marc Dewey
- Charité Center for Diagnostic and Interventional Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Valérie Vilgrain
- Université Paris Cité, Île-de-France, Paris, France
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, Department of Radiology, Île-de-France, Clichy, France
| | - Riccardo Sartoris
- Université Paris Cité, Île-de-France, Paris, France
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, Department of Radiology, Île-de-France, Clichy, France
| | - Maxime Ronot
- Université Paris Cité, Île-de-France, Paris, France
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, Department of Radiology, Île-de-France, Clichy, France
| | - Ariel Jaffe
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Mario Strazzabosco
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - John A Onofrey
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA.
- Department of Urology, Yale University School of Medicine, New Haven, CT, USA.
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16
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Agirrezabal I, Bouattour M, Pinato DJ, D'Alessio A, Brennan VK, Carion PL, Shergill S, Amoury N, Vilgrain V. Efficacy of transarterial radioembolization using Y-90 resin microspheres versus atezolizumab-bevacizumab in unresectable hepatocellular carcinoma: A matching-adjusted indirect comparison. Eur J Cancer 2024; 196:113427. [PMID: 37988840 DOI: 10.1016/j.ejca.2023.113427] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION No head-to-head trials compared the efficacy of transarterial radioembolization (TARE, also known as selective internal radiation therapy) to combination immunotherapy in hepatocellular carcinoma (HCC). The analysis objective was to compare effectiveness outcomes of TARE using Y-90 resin microspheres and atezolizumab-bevacizumab (AB) in advanced unresectable HCC. METHODS Patient-level data from SARAH randomized controlled trial for TARE and aggregate real-world data from AB-real study were used in an unanchored matching-adjusted indirect comparison. The basecase analysis used per-protocol data from SARAH; intention-to-treat data were used in sensitivity analyses. The following prognostic variables and effect modifiers were identified from literature: cause of disease, macrovascular invasion, Eastern Cooperative Oncology Group Performance Status, alpha-fetoprotein level and albumin-bilirubin score. Weights were assigned to patients from SARAH to balance baseline characteristics across studies and reflect characteristics of AB-real patients. Overall survival (OS), progression-free survival (PFS) and response rates (overall response rates [ORR]) were calculated and compared. RESULTS The analysis of OS and PFS included 140 patients receiving TARE and 131 for the analysis of response rates, compared to 202 receiving AB. Median OS was 15.0 and 14.9 months for TARE and AB, respectively (HR=0.980; 95% confidence interval [CI]: 0.658-1.461; p-value=0.922). Median PFS was 4.4 and 6.8 months for TARE and AB, respectively (HR=0.745; 95%CI: 0.544-1.022; p-value=0.068). ORR were 19.8% and 25% with TARE and AB, respectively (OR for AB=1.386, 95%CI: 0.746-2.668; p-value=0.306). Sensitivity analyses generated similar results. CONCLUSION In HCC patients receiving treatment, TARE using Y-90 resin microspheres may achieve comparable effectiveness outcomes compared with AB.
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Affiliation(s)
- Ion Agirrezabal
- Sirtex Medical Europe GmbH, Joseph-Schumpeter-Allee 33, 53227 Bonn, Germany.
| | - Mohamed Bouattour
- Assistance Publique-Hôpitaux de Paris, APHP Nord, Hôpital Beaujon, Clichy, France; Université de Paris Cité, Centre de Recherche de l'Inflammation (CRI), INSERM U1149, F-75018 Paris, France.
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, Universita' del Piemonte Orientale "A. Avogadro", Via Solaroli, Novara, Italy.
| | - Antonio D'Alessio
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, Universita' del Piemonte Orientale "A. Avogadro", Via Solaroli, Novara, Italy.
| | - Victoria K Brennan
- Sirtex Medical United Kingdom Ltd., Hill House, 1 Little New Street, London EC4A 3TR, United Kingdom.
| | - Phuong Lien Carion
- Sirtex Medical Europe GmbH, Joseph-Schumpeter-Allee 33, 53227 Bonn, Germany.
| | - Suki Shergill
- Sirtex Medical United Kingdom Ltd., Hill House, 1 Little New Street, London EC4A 3TR, United Kingdom.
| | - Nathalie Amoury
- Sirtex Medical Europe GmbH, Joseph-Schumpeter-Allee 33, 53227 Bonn, Germany.
| | - Valérie Vilgrain
- Assistance Publique-Hôpitaux de Paris, APHP Nord, Hôpital Beaujon, Clichy, France; Université de Paris Cité, Centre de Recherche de l'Inflammation (CRI), INSERM U1149, F-75018 Paris, France.
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17
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Taouli B, Ba-Ssalamah A, Chapiro J, Chhatwal J, Fowler K, Kang TW, Knobloch G, Koh DM, Kudo M, Lee JM, Murakami T, Pinato DJ, Ringe KI, Song B, Tabrizian P, Wang J, Yoon JH, Zeng M, Zhou J, Vilgrain V. Correction: Consensus report from the 10th global forum for liver magnetic resonance imaging: multidisciplinary team discussion. Eur Radiol 2024; 34:724-725. [PMID: 37930413 PMCID: PMC10791959 DOI: 10.1007/s00330-023-10342-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Bachir Taouli
- Department of Diagnostic, Molecular, and Interventional Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Jagpreet Chhatwal
- Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Fowler
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Tae Wook Kang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gesine Knobloch
- Global Medical and Clinical Affairs and Digital Development, Radiology, Bayer Pharmaceuticals, Berlin, Germany
| | - Dow-Mu Koh
- Department of Diagnostic Radiology, Royal Marsden Hospital, Sutton, UK
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Parissa Tabrizian
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jin Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou; Liver Disease Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jian Zhou
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Valérie Vilgrain
- Université Paris Cité and Department of Radiology, Assistance-Publique Hôpitaux de Paris, APHP Nord, Hôpital Beaujon, Clichy, France
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18
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McLin VA, Franchi-Abella S, Brütsch T, Bahadori A, Casotti V, de Ville de Goyet J, Dumery G, Gonzales E, Guérin F, Hascoet S, Heaton N, Kuhlmann B, Lador F, Lambert V, Marra P, Plessier A, Quaglia A, Rougemont AL, Savale L, Sarma MS, Sitbon O, Superina RA, Uchida H, van Albada M, Johannes van der Doef HP, Vilgrain V, Wacker J, Zwaveling N, Debray D, Wildhaber BE. Expert management of congenital portosystemic shunts and their complications. JHEP Rep 2024; 6:100933. [PMID: 38234409 PMCID: PMC10792643 DOI: 10.1016/j.jhepr.2023.100933] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 01/19/2024] Open
Abstract
Congenital portosystemic shunts are often associated with systemic complications, the most challenging of which are liver nodules, pulmonary hypertension, endocrine abnormalities, and neurocognitive dysfunction. In the present paper, we offer expert clinical guidance on the management of liver nodules, pulmonary hypertension, and endocrine abnormalities, and we make recommendations regarding shunt closure and follow-up.
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Affiliation(s)
- Valérie Anne McLin
- Swiss Pediatric Liver Center, Gastroenterology, Hepatology and Pediatric Nutrition Unit, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland
- ERN RARE LIVER
| | - Stéphanie Franchi-Abella
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
- AP-HP, Centre de référence des maladies rares du foie de l’enfant, Service de radiologie pédiatrique diagnostique et interventionnelle, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- BIOMAPS UMR 9011 CNRS, INSERM, CEA, Orsay, France
- ERN RARE LIVER
- ERN Transplant Child
| | | | - Atessa Bahadori
- Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland
| | - Valeria Casotti
- ERN Transplant Child
- Pediatric Hepatology, Gastroenterology and Transplant Centre, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Jean de Ville de Goyet
- Pediatric Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, ISMETT UPMC, Palermo, Italy
| | - Grégoire Dumery
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
- AP-HP, Service de gynécologie et d’obstétrique, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Emmanuel Gonzales
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
- ERN RARE LIVER
- ERN Transplant Child
- AP-HP, Centre de référence des maladies rares du foie de l’enfant, FHU Hepatinov, Service d’hépatologie et transplantation hépatique pédiatriques, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMRS_1193, Orsay, France
| | - Florent Guérin
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
- ERN RARE LIVER
- ERN Transplant Child
- AP-HP, Service de chirurgie pédiatrique, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sebastien Hascoet
- Department of Congenital Heart Diseases, Hôpital Marie Lannelongue, France
- INSERM UMR_S 999, Université Paris, France
| | - Nigel Heaton
- Institute of Liver Studies, Kings College Hospital, London, England
| | - Béatrice Kuhlmann
- Pediatric Endocrinology, Cantonal Hospital Aarau KSA, Aarau, Switzerland
| | - Frédéric Lador
- Service de Pneumologie, University of Geneva, Geneva, Switzerland
| | - Virginie Lambert
- AP-HP, Centre de référence des maladies rares du foie de l’enfant, Service de radiologie pédiatrique diagnostique et interventionnelle, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Cardiologie congénitale, Institut Mutualiste Montsouris, Paris, France
| | - Paolo Marra
- Department of Radiology, Papa Giovanni XXIII Hospital, School of Medicine and Surgery - University of Milano-Bicocca, Bergamo, Italy
| | - Aurélie Plessier
- ERN RARE LIVER
- Centre de référence des maladies vasculaires du foie, Service d’hépatologie Hôpital Beaujon, Clichy, France
- VALDIG
| | - Alberto Quaglia
- Department of Cellular Pathology, Royal Free London NHS Foundation Trust/UCL Cancer Institute, London, England
| | - Anne-Laure Rougemont
- Swiss Pediatric Liver Center, Division of Clinical Pathology, Diagnostic Department, University of Geneva, Geneva, Switzerland
| | - Laurent Savale
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
- AP-HP, Centre de référence de l’hypertension pulmonaire, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France
- ERN Lung
| | - Moinak Sen Sarma
- Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Olivier Sitbon
- Université Paris-Saclay, Faculté de médecine, Le Kremlin-Bicêtre, France
- AP-HP, Centre de référence de l’hypertension pulmonaire, Service de pneumologie et soins intensifs respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France
- ERN Lung
| | - Riccardo Antonio Superina
- Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
| | - Hajime Uchida
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mirjam van Albada
- Department of paediatric and congenital cardiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Hubert Petrus Johannes van der Doef
- Division of paediatric gastroenterology and hepatology, Department of paediatrics, University Medical Center Groningen, Groningen, The Netherlands
| | - Valérie Vilgrain
- ERN RARE LIVER
- VALDIG
- Université Paris Cité, CRI, INSERM, Paris, France
- AP-HP, Département de Radiologie, Hôpital Beaujon. Nord, Clichy, France
| | - Julie Wacker
- Pediatric Cardiology Unit, Department of pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland
- Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pédiatrique, University of Geneva and Lausanne, Switzerland
| | - Nitash Zwaveling
- Department of Pediatric Endocrinology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Dominique Debray
- ERN RARE LIVER
- ERN Transplant Child
- AP-HP, Unité d’hépatologie pédiatrique et transplantation hépatique, Hôpital Necker, Paris, France
- Centre de Référence des maladies rares du foie de l’enfant, FILFOIE, France
| | - Barbara Elisabeth Wildhaber
- ERN RARE LIVER
- Swiss pediatric Liver Center, Division of pediatric surgery, Department of Pediatrics, Gynecology, and Obstetrics, University of Geneva, Geneva, Switzerland
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19
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Taouli B, Ba-Ssalamah A, Chapiro J, Chhatwal J, Fowler K, Kang TW, Knobloch G, Koh DM, Kudo M, Lee JM, Murakami T, Pinato DJ, Ringe KI, Song B, Tabrizian P, Wang J, Yoon JH, Zeng M, Zhou J, Vilgrain V. Correction to: Consensus report from the 10th Global Forum for Liver Magnetic Resonance Imaging: developments in HCC management. Eur Radiol 2023:10.1007/s00330-023-10484-8. [PMID: 38112766 DOI: 10.1007/s00330-023-10484-8] [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] [Indexed: 12/21/2023]
Affiliation(s)
- Bachir Taouli
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-guided therapy, Medical University of Vienna, Vienna, Austria
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Jagpreet Chhatwal
- Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Fowler
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Tae Wook Kang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gesine Knobloch
- Radiology, Bayer Pharmaceuticals, Global Medical and Clinical Affairs and Digital Development, Berlin, Germany
| | - Dow-Mu Koh
- Department of Diagnostic Radiology, Royal Marsden Hospital, Sutton, UK
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Parissa Tabrizian
- Icahn School of Medicine at Mount Sinai, Recanati/Miller Transplantation Institute, New York, NY, USA
| | - Jin Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Liver Disease Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jian Zhou
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Valérie Vilgrain
- Université Paris Cité and Department of Radiology, Assistance-Publique Hôpitaux de Paris, APHP Nord, Hôpital Beaujon, Clichy, France
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20
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Dioguardi Burgio M, Castera L, Oufighou M, Rautou PE, Paradis V, Bedossa P, Sartoris R, Ronot M, Bodard S, Garteiser P, Van Beers B, Valla D, Vilgrain V, Correas JM. Prospective Comparison of Attenuation Imaging and Controlled Attenuation Parameter for Liver Steatosis Diagnosis in Patients With Nonalcoholic Fatty Liver Disease and Type 2 Diabetes. Clin Gastroenterol Hepatol 2023:S1542-3565(23)00999-0. [PMID: 38072287 DOI: 10.1016/j.cgh.2023.11.034] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/31/2023] [Accepted: 11/26/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND & AIMS Similarly to the controlled attenuation parameter (CAP), the ultrasound-based attenuation imaging (ATI) can quantify hepatic steatosis. We prospectively compared the performance of ATI and CAP for the diagnosis of hepatic steatosis in patients with type 2 diabetes and nonalcoholic fatty liver disease using histology and magnetic resonance imaging-proton density fat fraction (MRI-PDFF) as references. METHODS Patients underwent ATI and CAP measurement, MRI, and biopsy on the same day. Steatosis was classified as S0, S1, S2, and S3 on histology (<5%, 5%-33%, 33%-66%, and >66%, respectively) while the thresholds of 6.4%, 17.4%, and 22.1%, respectively, were used for MRI-PDFF. The area under the curve (AUC) of ATI and CAP was compared using a DeLong test. RESULTS Steatosis could be evaluated in 191 and 187 patients with MRI-PDFF and liver biopsy, respectively. For MRI-PDFF steatosis, the AUC of ATI and CAP were 0.86 (95% confidence interval [CI], 0.81-0.91) vs 0.69 (95% CI, 0.62-0.75) for S0 vs S1-S3 (P = .02) and 0.71 (95% CI, 0.64-0.77) vs 0.69 (95% CI, 0.61-0.75) for S0-S1 vs S2-S3 (P = .60), respectively. For histological steatosis, the AUC of ATI and CAP were 0.92 (95% CI, 0.87-0.95) vs 0.95 (95% CI, 0.91-0.98) for S0 vs S1-S3 (P = .64) and 0.79 (95% CI, 0.72-0.84) vs 0.76 (95% CI, 0.69-0.82) for S0-S1 vs S2-S3 (P = .61), respectively. CONCLUSION ATI may be used as an alternative to CAP for the diagnosis and quantification of steatosis, in patients with type 2 diabetes and nonalcoholic fatty liver disease.
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Affiliation(s)
- Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, AP-HP Nord, Clichy, France; Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France.
| | - Laurent Castera
- Departement of Hepatology, Hospital Beaujon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mehdi Oufighou
- Department of Radiology, Hôpital Beaujon, AP-HP Nord, Clichy, France
| | - Pierre-Emmanuel Rautou
- Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France; Service d'Hépatologie, AP-HP, Hôpital Beaujon, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Clichy, France
| | - Valérie Paradis
- Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France; Department of Pathology, Hôpital Beaujon, AP-HP Nord, Clichy, France
| | - Pierre Bedossa
- Department of Pathology, Hôpital Beaujon, AP-HP Nord, Clichy, France
| | - Riccardo Sartoris
- Department of Radiology, Hôpital Beaujon, AP-HP Nord, Clichy, France
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, AP-HP Nord, Clichy, France; Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France
| | - Sylvain Bodard
- Department of Adult Radiology, Necker University Hospital, AP-HP, Paris, France; Université Paris Cité, Paris, France
| | - Philippe Garteiser
- Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France
| | - Bernard Van Beers
- Department of Radiology, Hôpital Beaujon, AP-HP Nord, Clichy, France; Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France
| | - Dominique Valla
- Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France; Service d'Hépatologie, AP-HP, Hôpital Beaujon, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, AP-HP Nord, Clichy, France; Université Paris Cité, INSERM, Centre de Recherche sur L'inflammation, Paris, France
| | - Jean Michel Correas
- Department of Adult Radiology, Necker University Hospital, AP-HP, Paris, France; Université Paris Cité, Paris, France; Sorbonne Université, CNRS, INSERM Laboratoire d'Imagerie Biomédicale, Paris, France
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21
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Taouli B, Ba-Ssalamah A, Chapiro J, Chhatwal J, Fowler K, Kang TW, Knobloch G, Koh DM, Kudo M, Lee JM, Murakami T, Pinato DJ, Ringe KI, Song B, Tabrizian P, Wang J, Yoon JH, Zeng M, Zhou J, Vilgrain V. Consensus report from the 10th global forum for liver magnetic resonance imaging: multidisciplinary team discussion. Eur Radiol 2023; 33:9167-9181. [PMID: 37439935 PMCID: PMC10667403 DOI: 10.1007/s00330-023-09919-z] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 07/14/2023]
Abstract
The 10th Global Forum for Liver Magnetic Resonance Imaging was held in October 2021. The themes of the presentations and discussions at this Forum are described in detail in the review by Taouli et al (2023). The focus of this second manuscript developed from the Forum is on multidisciplinary tumor board perspectives in hepatocellular carcinoma (HCC) management: how to approach early-, mid-, and late-stage management from the perspectives of a liver surgeon, an interventional radiologist, and an oncologist. The manuscript also includes a panel discussion by multidisciplinary experts on three selected cases that explore challenging aspects of HCC management. CLINICAL RELEVANCE STATEMENT: This review highlights the importance of a multidisciplinary team approach in liver cancer patients and includes the perspectives of a liver surgeon, an interventional radiologist, and an oncologist, including illustrative case studies. KEY POINTS: • A liver surgeon, interventional radiologist, and oncologist presented their perspectives on the treatment of early-, mid-, and late-stage HCC. • Different perspectives on HCC management between specialties emphasize the importance of multidisciplinary tumor boards. • A multidisciplinary faculty discussed challenging aspects of HCC management, as highlighted by three case studies.
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Affiliation(s)
- Bachir Taouli
- Department of Diagnostic, Molecular, and Interventional Radiology, BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Jagpreet Chhatwal
- Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Fowler
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Tae Wook Kang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gesine Knobloch
- Global Medical and Clinical Affairs and Digital Development, Radiology, Bayer Pharmaceuticals, Berlin, Germany
| | - Dow-Mu Koh
- Department of Diagnostic Radiology, Royal Marsden Hospital, Sutton, UK
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Parissa Tabrizian
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jin Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou; Liver Disease Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jian Zhou
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Valérie Vilgrain
- Université Paris Cité and Department of Radiology, Assistance-Publique Hôpitaux de Paris, APHP Nord, Hôpital Beaujon, Clichy, France
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22
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Salameh N, Weingärtner S, Hilbert T, Vilgrain V, Robson MD, Marques JP. Quantitative imaging through the production chain: from idea to application. MAGMA 2023; 36:851-855. [PMID: 37950797 DOI: 10.1007/s10334-023-01131-w] [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] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/13/2023]
Affiliation(s)
- Najat Salameh
- Center for Adaptable MRI Technology (AMT Center), Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
- HollandPTC, Delft, The Netherlands
| | - Tom Hilbert
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, APHP.Nord, Université Paris Cité, Paris, France
| | | | - José P Marques
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands.
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23
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Taouli B, Ba-Ssalamah A, Chapiro J, Chhatwal J, Fowler K, Kang TW, Knobloch G, Koh DM, Kudo M, Lee JM, Murakami T, Pinato DJ, Ringe KI, Song B, Tabrizian P, Wang J, Yoon JH, Zeng M, Zhou J, Vilgrain V. Consensus report from the 10th Global Forum for Liver Magnetic Resonance Imaging: developments in HCC management. Eur Radiol 2023; 33:9152-9166. [PMID: 37500964 PMCID: PMC10730664 DOI: 10.1007/s00330-023-09928-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 07/29/2023]
Abstract
The 10th Global Forum for Liver Magnetic Resonance Imaging (MRI) was held as a virtual 2-day meeting in October 2021, attended by delegates from North and South America, Asia, Australia, and Europe. Most delegates were radiologists with experience in liver MRI, with representation also from specialists in liver surgery, oncology, and hepatology. Presentations, discussions, and working groups at the Forum focused on the following themes: • Gadoxetic acid in clinical practice: Eastern and Western perspectives on current uses and challenges in hepatocellular carcinoma (HCC) screening/surveillance, diagnosis, and management • Economics and outcomes of HCC imaging • Radiomics, artificial intelligence (AI) and deep learning (DL) applications of MRI in HCC. These themes are the subject of the current manuscript. A second manuscript discusses multidisciplinary tumor board perspectives: how to approach early-, mid-, and late-stage HCC management from the perspectives of a liver surgeon, interventional radiologist, and oncologist (Taouli et al, 2023). Delegates voted on consensus statements that were developed by working groups on these meeting themes. A consensus was considered to be reached if at least 80% of the voting delegates agreed on the statements. CLINICAL RELEVANCE STATEMENT: This review highlights the clinical applications of gadoxetic acid-enhanced MRI for liver cancer screening and diagnosis, as well as its cost-effectiveness and the applications of radiomics and AI in patients with liver cancer. KEY POINTS: • Interpretation of gadoxetic acid-enhanced MRI differs slightly between Eastern and Western guidelines, reflecting different regional requirements for sensitivity vs specificity. • Emerging data are encouraging for the cost-effectiveness of gadoxetic acid-enhanced MRI in HCC screening and diagnosis, but more studies are required. • Radiomics and artificial intelligence are likely, in the future, to contribute to the detection, staging, assessment of treatment response and prediction of prognosis of HCC-reducing the burden on radiologists and other specialists and supporting timely and targeted treatment for patients.
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Affiliation(s)
- Bachir Taouli
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-guided therapy, Medical University of Vienna, Vienna, Austria
| | - Julius Chapiro
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Jagpreet Chhatwal
- Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Fowler
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Tae Wook Kang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gesine Knobloch
- Global Medical and Clinical Affairs and Digital Development, Radiology, Bayer Pharmaceuticals, Berlin, Germany
| | - Dow-Mu Koh
- Department of Diagnostic Radiology, Royal Marsden Hospital, Sutton, UK
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Parissa Tabrizian
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jin Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Liver Disease Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, South Korea
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jian Zhou
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Valérie Vilgrain
- Université Paris Cité and Department of Radiology, Assistance-Publique Hôpitaux de Paris, APHP Nord, Hôpital Beaujon, Clichy, France
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Ducatel A, Trillaud H, Reizine E, Vilgrain V, Sempoux C, Schmidt-Kobbe S, Gouw ASH, de Haas RJ, Julien C, Paradis V, Blanc JF, Chiche L, Balabaud C, Bioulac-Sage P, Frulio N. Sonic hedgehog hepatocellular adenoma: magnetic resonance imaging features and correlation with histology. Eur Radiol 2023:10.1007/s00330-023-10344-5. [PMID: 38012454 DOI: 10.1007/s00330-023-10344-5] [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: 05/08/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES Sonic hedgehog hepatocellular adenoma (shHCA) is a new hepatocellular adenoma (HCA) subgroup characterized by high risk of hemorrhage. ShHCA account for below 10% of all HCA cases and are often associated with female gender, obesity, and non-alcoholic steatohepatitis. No specific MRI characteristics have been described to date. The objective of this study was to assess the value of using MRI to identify shHCA, and correlate MRI findings with histology. METHODS We retrospectively collected MRI scans of 29 patients with shHCA from our center and from different liver referral centers to include 35 lesions. Diagnosis of shHCA was assessed by immunohistochemical overexpression of argininosuccinate synthase 1 or prostaglandin D2 synthase, then confirmed by molecular analysis of sonic hedgehog pathway activation and/or by proteomic analysis. RESULTS In 46% (n = 16/35) of shHCA cases, we detected intralesional fluid-filled cavities defined on MR images as fluid-like foci markedly hyperintense on T2-weighted sequences, and hypointense on T1-weighted sequences, with or without delayed enhancement. Pathologically, these cavities were observed in 54% of cases as vacuoles filled with blood at different stages of degradation. Hemorrhage and/or necrosis were detected among 71% of cases by MRI analysis (n = 25/35) versus 82% pathologically. Seventeen percent of shHCA cases (n = 6/35) were completely homogeneous via MRI and pathological analysis. No MRI criteria was found in favor of focal nodular hyperplasia, HNF1A-mutated HCA, or typical inflammatory HCA. CONCLUSION We reveal the presence of intralesional fluid-filled cavities among 46% of our shHCA cases that represent a new MRI finding possibly helpful for shHCA diagnosis. CLINICAL RELEVANCE STATEMENT This multicenter study is the first clinical study about the radiological aspect of this new hepatocellular adenoma subgroup. This highlights a strong correlation between MRI and histological analysis, with a specific pattern emerging for diagnosis. KEY POINTS • Sonic hedgehog hepatocellular adenoma is a new hepatocellular adenoma subgroup associated with high risk of hemorrhage, but imaging features of this subgroup remain unknown. • Analysis of MR images and correlation with pathology revealed intralesional fluid-filled cavities and necrotic-hemorrhagic changes. • Intralesional fluid-filled cavities have not yet been described in other adenoma subtypes and represent a new MRI finding for sonic hedgehog hepatocellular adenoma.
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Affiliation(s)
- Arnaud Ducatel
- Department of Radiology, University Bordeaux Hospital, Hôpital Haut-Lévêque, F-33604, Pessac, France.
| | - Hervé Trillaud
- Department of Radiology, University Bordeaux Hospital, Hôpital Haut-Lévêque, F-33604, Pessac, France
| | - Edouard Reizine
- Department of Radiology, APHP Nord, Hôpital Beaujon, Université Paris Cité, Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, APHP Nord, Hôpital Beaujon, Université Paris Cité, Clichy, France
| | - Christine Sempoux
- Department of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Sabine Schmidt-Kobbe
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Annette S H Gouw
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - Robbert J de Haas
- Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Céline Julien
- Department of Digestive Surgery, University Bordeaux Hospital, Hôpital Haut-Lévêque, F-33604, Pessac, France
| | - Valérie Paradis
- Department of Pathology, APHP, Université de Paris, Hôpital Beaujon, Clichy, France
| | - Jean-Frédéric Blanc
- Department of Hepatogastroenterology and Digestive Oncology, University Bordeaux Hospital, Hôpital Haut-Lévêque, F-33604, Pessac, France
| | - Laurence Chiche
- Department of Digestive Surgery, University Bordeaux Hospital, Hôpital Haut-Lévêque, F-33604, Pessac, France
| | - Charles Balabaud
- UMR 1053, University Bordeaux, INSERM, F-33076, Bordeaux, France
| | | | - Nora Frulio
- Department of Radiology, University Bordeaux Hospital, Hôpital Haut-Lévêque, F-33604, Pessac, France
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25
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Dioguardi Burgio M, Garzelli L, Cannella R, Ronot M, Vilgrain V. Hepatocellular Carcinoma: Optimal Radiological Evaluation before Liver Transplantation. Life (Basel) 2023; 13:2267. [PMID: 38137868 PMCID: PMC10744421 DOI: 10.3390/life13122267] [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: 09/04/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Liver transplantation (LT) is the recommended curative-intent treatment for patients with early or intermediate-stage hepatocellular carcinoma (HCC) who are ineligible for resection. Imaging plays a central role in staging and for selecting the best LT candidates. This review will discuss recent developments in pre-LT imaging assessment, in particular LT eligibility criteria on imaging, the technical requirements and the diagnostic performance of imaging for the pre-LT diagnosis of HCC including the recent Liver Imaging Reporting and Data System (LI-RADS) criteria, the evaluation of the response to locoregional therapy, as well as the non-invasive prediction of HCC aggressiveness and its impact on the outcome of LT. We will also briefly discuss the role of nuclear medicine in the pre-LT evaluation and the emerging role of artificial intelligence models in patients with HCC.
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Affiliation(s)
- Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, AP-HP. Nord, 100 Boulevard du Général Leclerc, 92110 Clichy, France (V.V.)
- Centre de Recherche sur l’Inflammation, UMR1149, Université Paris Cité, 75018 Paris, France
| | - Lorenzo Garzelli
- Service d’Imagerie Medicale, Centre Hospitalier de Cayenne, Avenue des Flamboyants, Cayenne 97306, French Guiana
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, AP-HP. Nord, 100 Boulevard du Général Leclerc, 92110 Clichy, France (V.V.)
- Centre de Recherche sur l’Inflammation, UMR1149, Université Paris Cité, 75018 Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, AP-HP. Nord, 100 Boulevard du Général Leclerc, 92110 Clichy, France (V.V.)
- Centre de Recherche sur l’Inflammation, UMR1149, Université Paris Cité, 75018 Paris, France
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26
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Sidali S, Borie R, Sicre de Fontbrune F, El Husseini K, Rautou PE, Lainey E, Goria O, Crestani B, Cadranel J, Cottin V, Bunel V, Dumortier J, Jacquemin E, Reboux N, Hirschi S, Bourdin A, Meszaros M, Dharancy S, Hilaire S, Mallet V, Reynaud-Gaubert M, Terriou L, Gottrand F, Abou Chahla W, Khan JE, Carrier P, Saliba F, Rubbia-Brandt L, Aubert JD, Elkrief L, de Lédinghen V, Abergel A, Olivier T, Houssel P, Jouneau S, Wemeau L, Bergeron A, Leblanc T, Ollivier-Hourmand I, Nguyen Khac E, Morisse-Pradier H, Ba I, Boileau C, Roudot-Thoraval F, Vilgrain V, Bureau C, Nunes H, Naccache JM, Durand F, Francoz C, Roulot D, Valla D, Paradis V, Kannengiesser C, Plessier A. Liver disease in germline mutations of telomere-related genes: Prevalence, clinical, radiological, pathological features, outcome, and risk factors. Hepatology 2023:01515467-990000000-00633. [PMID: 37934624 DOI: 10.1097/hep.0000000000000667] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND AND AIM Germline mutations of telomere-related genes (TRG) induce multiorgan dysfunction, and liver-specific manifestations have not been clearly outlined. We aimed to describe TRG mutations-associated liver diseases. APPROACH AND RESULTS Retrospective multicenter analysis of liver disease (transaminases > 30 IU/L and/or abnormal liver imaging) in patients with TRG mutations. Main measurements were characteristics, outcomes, and risk factors of liver disease in a TRG mutations cohort. The prevalence of liver disease was compared to a community-based control group (n = 1190) stratified for age and matched 1:3 for known risk factors of liver disease. Among 132 patients with TRG mutations, 95 (72%) had liver disease, with associated lung, blood, skin, rheumatological, and ophthalmological TRG diseases in 82%, 77%, 55%, 39%, and 30% of cases, respectively. Liver biopsy was performed in 52/95 patients, identifying porto-sinusoidal vascular disease in 48% and advanced fibrosis/cirrhosis in 15%. After a follow-up of 21 months (12-54), ascites, hepato-pulmonary syndrome, variceal bleeding, and HCC occurred in 14%, 13%, 13%, and 2% of cases, respectively. Five-year liver transplantation-free survival was 69%. A FIB-4 score ≥ 3·25 and ≥1 risk factor for cirrhosis were associated with poor liver transplantation-free survival. Liver disease was more frequent in patients with TRG mutations than in the paired control group [80/396, (20%)], OR 12.9 (CI 95%: 7.8-21.3, p < 0.001). CONCLUSIONS TRG mutations significantly increase the risk of developing liver disease. Although symptoms may be mild, they may be associated with severe disease. Porto-sinusoidal vascular disease and cirrhosis were the most frequent lesions, suggesting that the mechanism of action is multifactorial.
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Affiliation(s)
- Sabrina Sidali
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Hépato-Gastroentérologie, Rouen, France
| | - Raphaël Borie
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | - Flore Sicre de Fontbrune
- Hematology Transplant Unit, Hôpital Saint louis, APHP, Paris, France, and French National Referral Center for Aplastic Anemia, CRMR
| | - Kinan El Husseini
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Pneumologie, Rouen, France
| | - Pierre-Emmanuel Rautou
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | - Odile Goria
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
- Centre Hospitalier Universitaire Charles Nicolle, Hépato-Gastroentérologie, Rouen, France
| | - Bruno Crestani
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | | | - Vincent Cottin
- Centre Hospitalier Universitaire Lyon Sud, Pneumologie, Pierre-Bénite, France
| | - Vincent Bunel
- APHP, Service de Pneumologie, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | | | - Emmanuel Jacquemin
- Hôpital Kremlin-Bicêtre AP-HP, Hépatologie Pédiatrique, Le Kremlin-Bicêtre, France
| | - Noémi Reboux
- Centre Hospitalier Régional Universitaire Morvan, Hépatologie, Brest, France
| | - Sandrine Hirschi
- Centre Hospitalier Universitaire de Strasbourg, Pneumologie, Strasbourg, France
| | - Arnaud Bourdin
- Centre Hospitalier Universitaire de Montpellier, Pneumologie, Montpellier, France
| | - Magdalena Meszaros
- Centre Hospitalier Universitaire de Montpellier, Hépatologie, Montpellier, France
| | - Sebastien Dharancy
- Centre Hospitalier Régional Universitaire de Lille, Hépatologie, Lille, France
| | | | | | | | - Louis Terriou
- Centre Hospitalier Régional Universitaire de Lille, Médecine interne- Hématologie, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, CHU Lille, Department of pediatric gastroenterology hepatology and nutrition, Inserm, Lille, France
| | - Wadih Abou Chahla
- Centre Hospitalier Régional Universitaire de Lille, Hémato-Pédiatrie, Lille, France
| | | | - Paul Carrier
- Hôpital Universitaire Dupuytren, Hépatologie, Limoges, France
| | - Faouzi Saliba
- Hôpital Paul-Brousse, AP-HP, Hépatologie, Villejuif, France
| | | | - John-David Aubert
- Centre Hospitalier Universitaire Vaudois, Pneumologie, Lausanne, Suisse
| | - Laure Elkrief
- Centre Hospitalier Régional Universitaire de Tours, Hépatologie, Tours, France
| | - Victor de Lédinghen
- Centre Hospitalier Universitaire - Haut-Lévêque, Hépatologie, Pessac, France
| | - Armand Abergel
- Centre Hospitalier Universitaire, Hépatologie, Clermont-Ferrand, France
| | | | - Pauline Houssel
- Centre Hospitalier Universitaire, Hépatologie, Rennes, France
| | | | - Lidwine Wemeau
- Centre Hospitalier Régional Universitaire de Lille, Pneumologie, Lille, France
| | - Anne Bergeron
- Hôpitaux Universitaires de Genève (HUG), Pneumologie, Genève, Suisse
| | - Thierry Leblanc
- Hematology Transplant Unit, Hôpital Saint louis, APHP, Paris, France, and French National Referral Center for Aplastic Anemia, CRMR
| | | | - Eric Nguyen Khac
- Centre Hospitalier Universitaire Amiens-Picardie Site Sud, Hépatologie, Amiens, France
| | | | - Ibrahima Ba
- Hôpital Bichat-Claude Bernard AP-HP, Génétique, Paris, France
| | | | | | | | | | - Hilario Nunes
- Hôpital Avicenne AP-HP, Pneumologie, Bobigny, France
| | | | - François Durand
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | - Claire Francoz
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | - Dominique Valla
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
| | | | | | - Aurélie Plessier
- Université de Paris, AP-HP, C, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation, Inserm, Paris, France
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27
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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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28
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Kirchner A, Ronot M, Durand F, Dondero F, Lesurtel M, Francoz C, Roux O, Lebtahi R, Vilgrain V, Dioguardi Burgio M. CT Volumetry Can Be Used for Monitoring Liver Function Recovery in Auxiliary Partial Orthotopic Liver Transplantation. Transplantation 2023; 107:2406-2414. [PMID: 37095611 DOI: 10.1097/tp.0000000000004608] [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: 04/26/2023]
Abstract
BACKGROUND Scintigraphy with a 99m TC-trimethyl-Br-IDA tracer (TBIDA) is used to monitor liver function regeneration after auxiliary partial orthotopic liver transplantation (APOLT) for acute liver failure (ALF). As computed tomography (CT) is also regularly performed during patient follow-up, CT volumetry could be used as an alternative to monitor native liver recovery after APOLT for ALF. METHODS This was a retrospective cohort study of all patients who underwent APOLT (October 2006-July 2019). Collected data included liver graft and native liver CT volumetry measurements (expressed as fractions), TBIDA scintigraphy results, and biological and clinical data including immunosuppression therapy after APOLT. Four follow-up time points were defined (baseline, discontinuation of mycophenolate mofetil, beginning of tacrolimus reduction, and tacrolimus discontinuation) for analysis. RESULTS Twenty-four patients (7 men; median age 28.5 y old) were included. The main etiologies of ALF were acetaminophen intoxication (n = 12), hepatitis B virus (n = 5), and amanita phalloides intoxication (n = 3). The median native liver function fractions on scintigraphy at baseline, at discontinuation of mycophenolate mofetil, at tacrolimus reduction, and at tacrolimus discontinuation were 22.0% (interquartile range 14.0-30.8), 30.5% (21.5-49.0), 32.0% (28.0-62.0), and 93.0% (77.0-100.0), respectively. The corresponding median native liver volume fractions on CT were 12.8% (10.4-17.3), 20.5% (14.2-27.3), 24.7% (21.3-48.4), and 77.9% (62.5-96.9), respectively. Volume and function were strongly correlated (r = 0.918; 95% confidence interval, 0.878-0.945; P < 0.01). Median time-to-immunosuppression discontinuation was 25.0 (17.0-35.0) mo. Estimated time-to-immunosuppression discontinuation was shorter in patients with acetaminophen-induced ALF (22 versus 35 mo; P = 0.035). CONCLUSIONS In patients who receive APOLT for ALF, CT-based liver volumetry closely parallels native liver function recovery evaluated on TBIDA scintigraphy.
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Affiliation(s)
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018 Paris, France
| | | | - Federica Dondero
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Clichy, France
| | - Mickael Lesurtel
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Clichy, France
| | - Claire Francoz
- Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Olivier Roux
- Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Rachida Lebtahi
- Department of Nuclear Medicine, Hôpital Beaujon, Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018 Paris, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, Clichy, France
- Université Paris Cité, Inserm, Centre de recherche sur l'inflammation, F-75018 Paris, France
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Cannella R, Santinha J, Bèaufrere A, Ronot M, Sartoris R, Cauchy F, Bouattour M, Matos C, Papanikolaou N, Vilgrain V, Dioguardi Burgio M. Performances and variability of CT radiomics for the prediction of microvascular invasion and survival in patients with HCC: a matter of chance or standardisation? Eur Radiol 2023; 33:7618-7628. [PMID: 37338558 DOI: 10.1007/s00330-023-09852-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/29/2022] [Revised: 03/28/2023] [Accepted: 04/21/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES To measure the performance and variability of a radiomics-based model for the prediction of microvascular invasion (MVI) and survival in patients with resected hepatocellular carcinoma (HCC), simulating its sequential development and application. METHODS This study included 230 patients with 242 surgically resected HCCs who underwent preoperative CT, of which 73/230 (31.7%) were scanned in external centres. The study cohort was split into training set (158 patients, 165 HCCs) and held-out test set (72 patients, 77 HCCs), stratified by random partitioning, which was repeated 100 times, and by a temporal partitioning to simulate the sequential development and clinical use of the radiomics model. A machine learning model for the prediction of MVI was developed with least absolute shrinkage and selection operator (LASSO). The concordance index (C-index) was used to assess the value to predict the recurrence-free (RFS) and overall survivals (OS). RESULTS In the 100-repetition random partitioning cohorts, the radiomics model demonstrated a mean AUC of 0.54 (range 0.44-0.68) for the prediction of MVI, mean C-index of 0.59 (range 0.44-0.73) for RFS, and 0.65 (range 0.46-0.86) for OS in the held-out test set. In the temporal partitioning cohort, the radiomics model yielded an AUC of 0.50 for the prediction of MVI, a C-index of 0.61 for RFS, and 0.61 for OS, in the held-out test set. CONCLUSIONS The radiomics models had a poor performance for the prediction of MVI with a large variability in the model performance depending on the random partitioning. Radiomics models demonstrated good performance in the prediction of patient outcomes. CLINICAL RELEVANCE STATEMENT Patient selection within the training set strongly influenced the performance of the radiomics models for predicting microvascular invasion; therefore, a random approach to partitioning a retrospective cohort into a training set and a held-out set seems inappropriate. KEY POINTS • The performance of the radiomics models for the prediction of microvascular invasion and survival widely ranged (AUC range 0.44-0.68) in the randomly partitioned cohorts. • The radiomics model for the prediction of microvascular invasion was unsatisfying when trying to simulate its sequential development and clinical use in a temporal partitioned cohort imaged with a variety of CT scanners. • The performance of the radiomics models for the prediction of survival was good with similar performances in the 100-repetition random partitioning and temporal partitioning cohorts.
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Affiliation(s)
- Roberto Cannella
- Department of Radiology, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France
- Section of Radiology-BiND, University Hospital 'Paolo Giaccone', Palermo, Italy
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
| | - Joao Santinha
- Champalimaud Foundation-Centre for the Unknown, 1400-038, Lisbon, Portugal
| | | | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France
- Université de Paris, INSERM U1149 'centre de recherche sur l'inflammation', CRI, Paris, France
| | - Riccardo Sartoris
- Department of Radiology, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France
- Université de Paris, INSERM U1149 'centre de recherche sur l'inflammation', CRI, Paris, France
| | - Francois Cauchy
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Clichy, France
| | | | - Celso Matos
- Champalimaud Foundation-Centre for the Unknown, 1400-038, Lisbon, Portugal
| | | | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France
- Université de Paris, INSERM U1149 'centre de recherche sur l'inflammation', CRI, Paris, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
- Université de Paris, INSERM U1149 'centre de recherche sur l'inflammation', CRI, Paris, France.
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Garzelli L, Ben Abdallah I, Nuzzo A, Zappa M, Corcos O, Dioguardi Burgio M, Cazals-Hatem D, Rautou PE, Vilgrain V, Calame P, Ronot M. Insights into acute mesenteric ischaemia: an up-to-date, evidence-based review from a mesenteric stroke centre unit. Br J Radiol 2023; 96:20230232. [PMID: 37493183 PMCID: PMC10607400 DOI: 10.1259/bjr.20230232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/09/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 07/27/2023] Open
Abstract
Radiologists play a central role in the diagnostic and prognostic evaluation of patients with acute mesenteric ischaemia (AMI). Unfortunately, more than half of AMI patients undergo imaging with no prior suspicion of AMI, making identifying this disease even more difficult. A confirmed diagnosis of AMI is ideally made with dynamic contrast-enhanced CT but the diagnosis may be made on portal-venous phase images in appropriate clinical settings. AMI is diagnosed on CT based on the identification of vascular impairment and bowel ischaemic injury with no other cause. Moreover, radiologists must evaluate the probability of bowel necrosis, which will influence the treatment options.AMI is usually separated into different entities: arterial, venous, non-occlusive and ischaemic colitis. Arterial AMI can be occlusive or stenotic, the dominant causes being atherothrombosis, embolism and isolated superior mesenteric artery (SMA) dissection. The main finding in the bowel is decreased wall enhancement, and necrosis can be suspected when dilatation >25 mm is identified. Venous AMI is related to superior mesenteric vein (SMV) thrombosis as a result of a thrombophilic state (acquired or inherited), local injury (cancer, inflammation or trauma) or underlying SMV insufficiency. The dominant features in the bowel are hypoattenuating wall thickening with submucosal oedema. Decreased enhancement of the involved bowel suggests necrosis. Non-occlusive mesenteric ischaemia (NOMI) is related to impaired SMA flow following global hypoperfusion associated with low-flow states. There are numerous findings in the bowel characterised by diffuse extension. An absence of bowel enhancement and a thin bowel wall suggest necrosis in NOMI. Finally, ischaemic colitis is a sub-entity of arterial AMI and reflects localised colon ischaemia-reperfusion injury. The main CT finding is a thickened colon wall with fat stranding, which seems to be unrelated to SMA or inferior mesenteric artery lesions. A precise identification and description of vascular lesions, bowel involvement and features associated with transmural necrosis is needed to determine patient treatment and outcome.
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Affiliation(s)
| | - Iannis Ben Abdallah
- Université Paris Cité, France & Service de chirurgie vasculaire, Hôpital Bichat, APHP.Nord, Paris, France
| | - Alexandre Nuzzo
- Intestinal Stroke Center, Service de gastroenterologie, MICI et Insuffisance intestinale, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Magaly Zappa
- Université des Antilles & Service de radiologie, Centre Hospitalier André Rosemon, Cayenne, France
| | - Olivier Corcos
- Intestinal Stroke Center, Service de gastroenterologie, MICI et Insuffisance intestinale, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Marco Dioguardi Burgio
- Université Paris Cité, France & Service de radiologie, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Dominique Cazals-Hatem
- Université Paris Cité, France & Service d’anatomopathologie, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Pierre-Emmanuel Rautou
- Université Paris Cité, France & Service d’hépatologie, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Valérie Vilgrain
- Université Paris Cité, France & Service de radiologie, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Paul Calame
- Université Bourgogne Franche-comté, Service de radiologie, CHU Besançon, France
| | - Maxime Ronot
- Université Paris Cité, France & Service de radiologie, Hôpital Beaujon, APHP.Nord, Clichy, France
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Pravisani R, Cocchi L, Cesaretti M, Dondero F, Sepulveda A, Farges O, Weiss E, Vilgrain V, Francoz C, Roux O, Belghiti J, Durand F, Lesurtel M, Dokmak S. Refining Auxiliary Orthotopic Liver Transplantation (AOLT) Improves Outcomes in Adult Patients With Acute Liver Failure. Ann Surg 2023; 278:790-797. [PMID: 37470188 DOI: 10.1097/sla.0000000000006019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/21/2023]
Abstract
OBJECTIVE To investigate whether and how experience accumulation and technical refinements simultaneously implemented in auxiliary orthotopic liver transplantation (AOLT) may impact on outcomes. BACKGROUND AOLT for acute liver failure (ALF) provides the unique chance of complete immunosuppression withdrawal after adequate native liver remnant regeneration but is a technically demanding procedure. Our department is a reference center for ALF and an early adopter of AOLT. METHODS This is a single-center retrospective before/after study of a prospectively maintained cohort of 48 patients with ALF who underwent AOLT between 1993 and 2019. In 2012, technical refinements were implemented to improve outcomes: (i) favoring the volume of the graft rather than that of the native liver, (ii) direct anastomosis of graft hepatic artery with recipient right hepatic artery instead of the use of large size vessels, (iii) end-to-side hepaticocholedocostomy instead of bilioenteric anastomosis. Early experience (1993-2011) group (n=26) and recent experience (2012-2019) group (n=22) were compared. Primary endpoint was 90-day severe morbidity rate (Clavien-Dindo≥IIIa) and secondary endpoints were overall patient survival and complete immunosuppression withdrawal rates. RESULTS Compared with the earlier experience group, the recent experience group was associated with a lower severe complication rate (27% vs 65%, P <0.001), as well as less biliary (18% vs 54%, P =0.017) and arterial (0% vs 15%, P =0.115) complications. The 1-, 3-, and 5-year patient survival was significantly improved (91%, 91%, 91% vs 76%, 61%, 60%, P =0.045). The rate of complete immunosuppression withdrawal increased to 94% vs 70%, ( P =0.091) with no need of long-term graft explant. CONCLUSION These technical refinements favoring the liver graft and reducing morbidity may promote AOLT implementation among LT centers.
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Affiliation(s)
- Riccardo Pravisani
- Liver-Kidney Transplant Unit, Department of Medicine, University of Udine, Udine, Italy
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Lorenzo Cocchi
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Manuela Cesaretti
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Federica Dondero
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Ailton Sepulveda
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Olivier Farges
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Emmanuel Weiss
- Department of Anesthesiology and Critical Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Claire Francoz
- Hepatology and Liver Intensive Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Olivier Roux
- Hepatology and Liver Intensive Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Jacques Belghiti
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Francois Durand
- Hepatology and Liver Intensive Care, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Mickaël Lesurtel
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
| | - Safi Dokmak
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Clichy, France
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Mulé S, Ronot M, Ghosn M, Sartoris R, Corrias G, Reizine E, Morard V, Quelever R, Dumont L, Hernandez Londono J, Coustaud N, Vilgrain V, Luciani A. Automated CT LI-RADS v2018 scoring of liver observations using machine learning: A multivendor, multicentre retrospective study. JHEP Rep 2023; 5:100857. [PMID: 37771548 PMCID: PMC10522871 DOI: 10.1016/j.jhepr.2023.100857] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 06/21/2023] [Accepted: 07/12/2023] [Indexed: 09/30/2023] Open
Abstract
Background & Aims Assessment of computed tomography (CT)/magnetic resonance imaging Liver Imaging Reporting and Data System (LI-RADS) v2018 major features leads to substantial inter-reader variability and potential decrease in hepatocellular carcinoma diagnostic accuracy. We assessed the performance and added-value of a machine learning (ML)-based algorithm in assessing CT LI-RADS major features and categorisation of liver observations compared with qualitative assessment performed by a panel of radiologists. Methods High-risk patients as per LI-RADS v2018 with pathologically proven liver lesions who underwent multiphase contrast-enhanced CT at diagnosis between January 2015 and March 2019 in seven centres in five countries were retrospectively included and randomly divided into a training set (n = 84 lesions) and a test set (n = 345 lesions). An ML algorithm was trained to classify non-rim arterial phase hyperenhancement, washout, and enhancing capsule as present, absent, or of uncertain presence. LI-RADS major features and categories were compared with qualitative assessment of two independent readers. The performance of a sequential use of the ML algorithm and independent readers were also evaluated in a triage and an add-on scenario in LR-3/4 lesions. The combined evaluation of three other senior readers was used as reference standard. Results A total of 318 patients bearing 429 lesions were included. Sensitivity and specificity for LR-5 in the test set were 0.67 (95% CI, 0.62-0.72) and 0.91 (95% CI, 0.87-0.96) respectively, with 242 (70.1%) lesions accurately categorised. Using the ML algorithm in a triage scenario improved the overall performance for LR-5. (0.86 and 0.93 sensitivity, 0.82 and 0.76 specificity, 78% and 82.3% accuracy for the two independent readers). Conclusions Quantitative assessment of CT LI-RADS v2018 major features is feasible and diagnoses LR-5 observations with high performance especially in combination with the radiologist's visual analysis in patients at high-risk for HCC. Impact and implications Assessment of CT/MRI LI-RADS v2018 major features leads to substantial inter-reader variability and potential decrease in hepatocellular carcinoma diagnostic accuracy. Rather than replacing radiologists, our results highlight the potential benefit from the radiologist-artificial intelligence interaction in improving focal liver lesions characterisation by using the developed algorithm as a triage tool to the radiologist's visual analysis. Such an AI-enriched diagnostic pathway may help standardise and improve the quality of analysis of liver lesions in patients at high risk for HCC, especially in non-expert centres in liver imaging. It may also impact the clinical decision-making and guide the clinician in identifying the lesions to be biopsied, for instance in patients with multiple liver focal lesions.
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Affiliation(s)
- Sébastien Mulé
- Service d'Imagerie Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
- Faculté de Santé, Université Paris Est Créteil, Créteil, France
- INSERM IMRB, U 955, Equipe 18, Créteil, France
| | - Maxime Ronot
- Service de Radiologie, Hôpital Beaujon, AP-HP Nord, Clichy, France
- Université de Paris, CRI, INSERM U1149, Paris, France
| | - Mario Ghosn
- Service d'Imagerie Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
- Faculté de Santé, Université Paris Est Créteil, Créteil, France
| | | | - Giuseppe Corrias
- Service de Radiologie, Hôpital Beaujon, AP-HP Nord, Clichy, France
| | - Edouard Reizine
- Service d'Imagerie Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
- Faculté de Santé, Université Paris Est Créteil, Créteil, France
- INSERM IMRB, U 955, Equipe 18, Créteil, France
| | | | | | | | | | | | - Valérie Vilgrain
- Service de Radiologie, Hôpital Beaujon, AP-HP Nord, Clichy, France
- Université de Paris, CRI, INSERM U1149, Paris, France
| | - Alain Luciani
- Service d'Imagerie Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
- Faculté de Santé, Université Paris Est Créteil, Créteil, France
- INSERM IMRB, U 955, Equipe 18, Créteil, France
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Poté N, Caruso S, Caderaro J, Cauchy F, Lagadec F, Couchy G, Raffenne J, Augustin J, Vernuccio F, Vilgrain V, Hercent A, Theou-Anton N, Zucman-Rossi J, Paradis V. Borderline Hepatocellular Adenomas: A Practical Diagnostic Approach Based on Pathologic and Molecular Features. Mod Pathol 2023; 36:100211. [PMID: 37169258 DOI: 10.1016/j.modpat.2023.100211] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
Borderline hepatocellular adenomas (BL-HCA) are characterized by focal architectural/cytologic atypia and reticulin loss, features that are insufficient for a definitive diagnosis of hepatocellular carcinoma (HCC). The diagnosis and management of BL-HCA are challenging as their biological behavior, especially in terms of malignant potential, is still debated. We aimed to compare the clinicopathologic and molecular features of BL-HCA with those of typical HCA (T-HCA), HCA with malignant transformation (HCC on HCA), and HCC to assess the risk of malignancy. One hundred six liver resection specimens were retrospectively selected from 2 reference centers, including 39 BL-HCA, 42 T-HCA, 12 HCC on HCA, and 13 HCC specimens. Somatic mutations, including TERT promoter mutations associated with HCA malignant transformation and the gene expression levels of 96 genes, were investigated in 93 frozen samples. Additionally, TERT promoter mutations were investigated in 44 formalin-fixed, paraffin-embedded samples. The clinical features of patients with BL-HCA were similar to those of patients with T-HCA, patients being mainly women (69%) with a median age of 37 years. The median tumor size was 7.5 cm, 64% of patients had a single nodule, and no recurrence was observed. Compared with T-HCA, BL-HCA was significantly enriched in β-catenin-mutated HCA in exon 3 (41% vs 6%; P < .001). Unsupervised statistical analysis based on gene expression showed that BL-HCA overlapped with T-HCA and HCC on HCA, favoring a molecular continuum of the tumors. TERT promoter mutations were observed only in HCC on HCA (42%) and in HCC (38%). In conclusion, these results suggest that despite their worrisome morphologic features, the clinicopathologic and molecular features of BL-HCA are much closer to those of T-HCA than those of HCC on HCA or HCC. This strongly supports the usefulness of combining morphologic and molecular analyses in a practical diagnostic approach for guiding the management of BL-HCA.
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Affiliation(s)
- Nicolas Poté
- Université Paris Cité, INSERM UMR-1149, Paris, France; Department of Pathology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France.
| | - Stefano Caruso
- Centre de Recherche des Cordeliers, Sorbonne Université-Université Paris Cité, INSERM, Paris, France; Team Fungest, Equipe labellisée Ligue Nationale Contre le Cancer, Labex immuno-Oncology, Paris, France
| | - Julien Caderaro
- Department of Pathology, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France; Team 18, Faculté de Médecine, Université Paris-Est Créteil, INSERM UMR-955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - François Cauchy
- Department of Hepatobiliary Surgery and Liver Transplantation, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Floriane Lagadec
- Department of Pathology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Gabrielle Couchy
- Centre de Recherche des Cordeliers, Sorbonne Université-Université Paris Cité, INSERM, Paris, France; Team Fungest, Equipe labellisée Ligue Nationale Contre le Cancer, Labex immuno-Oncology, Paris, France
| | | | - Jeremy Augustin
- Department of Pathology, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Federica Vernuccio
- Department of Radiology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Valérie Vilgrain
- Université Paris Cité, INSERM UMR-1149, Paris, France; Department of Radiology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Agathe Hercent
- Department of Genetics, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nathalie Theou-Anton
- Department of Genetics, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jessica Zucman-Rossi
- Centre de Recherche des Cordeliers, Sorbonne Université-Université Paris Cité, INSERM, Paris, France; Team Fungest, Equipe labellisée Ligue Nationale Contre le Cancer, Labex immuno-Oncology, Paris, France; Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Valérie Paradis
- Université Paris Cité, INSERM UMR-1149, Paris, France; Department of Pathology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
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Randriamandimby T, Vaittinada Ayar P, Bellamine A, Gay M, Benhammada D, Couve B, Zaghia D, Vilgrain V, Vaittinada Ayar P. Effects of anticipated prescription of radiography by the triage nurse on the waiting time in an emergency department. Int Emerg Nurs 2023; 70:101326. [PMID: 37611333 DOI: 10.1016/j.ienj.2023.101326] [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: 11/21/2022] [Revised: 06/24/2023] [Accepted: 07/07/2023] [Indexed: 08/25/2023]
Affiliation(s)
| | - Pradeebane Vaittinada Ayar
- Laboratoire des Sciences du Climat et l'Environnement (LSCE-IPSL) CNRS/CEA/UVSQ, UMR8212, Université Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Ali Bellamine
- Innovation and Data Department, AP-HP, Paris, France
| | - Matthieu Gay
- Emergency Department, Hospital Beaujon, AP-HP.Nord, Clichy, France
| | | | - Boris Couve
- Emergency Department, Hospital Beaujon, AP-HP.Nord, Clichy, France
| | - Damien Zaghia
- Emergency Department, Hospital Beaujon, AP-HP.Nord, Clichy, France
| | - Valérie Vilgrain
- Radiology Department, Hospital Beaujon, AP-HP.Nord, Clichy, France
| | - Prabakar Vaittinada Ayar
- Emergency Department, Hospital Beaujon, AP-HP.Nord, Clichy, France; INSERM UMR-S942, MASCOTT, Paris, France; University of Paris Cité, Paris, France.
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Gaudemer A, Haegel A, Dioguardi Burgio M, Vilgrain V, Grégory J, Ronot M. Who publishes imaging articles in non-imaging journals? A large sample data-mining study. Eur Radiol 2023; 33:5653-5663. [PMID: 36820924 DOI: 10.1007/s00330-023-09495-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/04/2022] [Accepted: 01/27/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVES To assess the weight of imaging and imaging specialists (i.e., affiliated to a radiology/nuclear medicine department) in publications in non-imaging journals. METHODS All articles indexed in English on the Embase database between 1989 and 2019 were extracted. The number and affiliation of authors were determined. A naive Bayesian classifier algorithm was trained to classify abstracts as "imaging" or "non-imaging." The main outcome was the number and position of imaging specialists in the authorship of imaging articles published in non-imaging journals. Analyses per medical specialties and per journal impact factor (IF) were performed. RESULTS A total of 15,787,825 articles were included with 968,259 (6%) "imaging" articles. The proportion of imaging articles increased over time (+ 370%), quicker than the overall academic output. The proportion of imaging specialist among authors grew from 0.58% in 1989-1994 to 1.54% in 2015-2019. About 20% of imaging articles had ≥ 1 imaging specialist among authors. The proportion of imaging articles decreased with the IF (7.3% for IF 0-2.5 vs. 5.1% for IF > 10, p < 0.001), but the proportion of imaging specialist authors in imaging papers with ≥ 1 imaging specialist author increased with the IF (40% for IF 0-2.5, 53% for IF > 10, p < 0.001). There was significant variability across medical specialties. CONCLUSIONS The weight of imaging articles and imaging specialist among authors in non-imaging journals has increased over time but remains limited. Most of the authors of imaging publications are not imaging specialists. Imaging specialists among authors in imaging papers are associated with a greater IF. KEY POINTS • The proportion of imaging specialist authors in non-imaging journals, though small, has increased significantly. • Marked differences are observed according to medical specialties and the reputation/impact factor of the journal. • Collaboration between imaging specialists and non-specialists is associated with publication in higher impact journals.
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Affiliation(s)
- Augustin Gaudemer
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France
- Department of Radiology, APHP.Nord, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France
| | | | - Marco Dioguardi Burgio
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France
| | - Valérie Vilgrain
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France
| | - Jules Grégory
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France
- FHU Mosaic, Clichy, France
| | - Maxime Ronot
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France.
- Department of Radiology, APHP.Nord, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
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Brustia R, Bouattour M, Allaire M, Lequoy M, Hollande C, Regnault H, Blaise L, Ganne-Carrié N, Vilgrain V, Larrey E, Lim C, Scatton O, Mouhadi SE, Ozenne V, Paye F, Balladur P, Dohan A, Massault PP, Pol S, Dioguardi Burgio M, Sepulveda A, Cauchy F, Luciani A, Sommacale D, Leroy V, Calderaro J, Roudot-Thoraval F, Nault JC, Amaddeo G. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area: What's new 12 months later? Ann Hepatol 2023; 28:101141. [PMID: 37468096 DOI: 10.1016/j.aohep.2023.101141] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION AND OBJECTIVES The lockdown policy introduced in 2020 to minimize the spread of the COVID-19 pandemic, significantly affected the management and care of patients affected by hepatocellular carcinoma (HCC). The aim of this follow-up study was to determine the 12 months impact of the COVID-19 pandemic on the cohort of patients affected by HCC during the lockdown, within six French academic referral centers in the metropolitan area of Paris. MATERIALS AND METHODS We performed a 12 months follow-up of the cross-sectional study cohort included in 2020 on the management of patients affected by HCC during the first six weeks of the COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed). Overall survival were compared between the groups. Predictors of mortality were analysed with Cox regression. RESULTS From the initial cohort, 575 patients were included (n = 263 Exposed_COVID, n = 312 Unexposed_COVID). Overall and disease free survival at 12 months were 59.9 ± 3.2% vs 74.3 ± 2.5% (p<0.001) and 40.2 ± 3.5% vs 63.5 ± 3.1% (p<0.001) according to the period of exposure (Exposed_COVID vs Unexposed_COVID, respectively). Adjusted Cox regression revealed that the period of exposure (Exposed_COVID HR: 1.79, 95%CI (1.36, 2.35) p<0.001) and BCLC stage B, C and D (BCLC B HR: 1.82, 95%CI (1.07, 3.08) p = 0.027 - BCLC C HR: 1.96, 95%CI (1.14, 3.38) p = 0.015 - BCLC D HR: 3.21, 95%CI (1.76, 5.85) p<0.001) were predictors of death. CONCLUSIONS Disruption of routine healthcare services because of the pandemic translated to reduced 1 year overall and disease-free survival among patients affected by HCC, in the metropolitan area of Paris, France.
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Affiliation(s)
- Raffaele Brustia
- Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France.
| | - Mohamed Bouattour
- Département d'Oncologie Hépatique, AP-HP, Hôpital Beaujon, F-92110 Clichy, France
| | - Manon Allaire
- Sorbonne Université, Paris, France; Hepatology and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Marie Lequoy
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Clémence Hollande
- Department of Hepatology, AP-HP, Hôpital Cochin, F-75014 Paris, France
| | - Hélène Regnault
- Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France
| | - Lorraine Blaise
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France
| | - Nathalie Ganne-Carrié
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors laboratory, F-75006, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France - INSERM U1149 "centre de recherche sur l'inflammation", CRI, Paris France
| | - Edouard Larrey
- Sorbonne Université, Paris, France; Hepatology and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Chetana Lim
- Digestive and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Olivier Scatton
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France; Digestive and Liver transplantation department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Hôpital de la Pitié-Salpêtrière, F-75013 Paris, France
| | - Sanaa El Mouhadi
- Department of Radiology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Violaine Ozenne
- Department of Hepatology, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - François Paye
- Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Pierre Balladur
- Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, F-75012 Paris, France
| | - Anthony Dohan
- Department of Radiology, AP-HP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Pierre-Philippe Massault
- Department of Digestive Surgery, AP-HP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Stanislas Pol
- Department of Hepatology, AP-HP, Hôpital Cochin, F-75014 Paris, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France - INSERM U1149 "centre de recherche sur l'inflammation", CRI, Paris France
| | - Ailton Sepulveda
- Digestive and Liver transplantation department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
| | - Francois Cauchy
- Digestive and Liver transplantation department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
| | - Alain Luciani
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Radiology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Daniele Sommacale
- Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Vincent Leroy
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France
| | - Julien Calderaro
- Université Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France; Assistance Publique-Hôpitaux de Paris, Henri Mondor-Albert Chenevier University Hospital, Department of Pathology, Créteil, France; Inserm, U955, Team 18, Créteil, France; European Reference Network (ERN) RARE-LIVER, France
| | | | - Jean-Charles Nault
- Service d'hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors laboratory, F-75006, Paris, France
| | - Giuliana Amaddeo
- INSERM U955, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers", Créteil, France - Assistance Publique-Hôpitaux de Paris, France; Department of Hepatology, AP-HP, Hôpital Henri-Mondor, F-94010 Créteil, France; Paris Est Créteil University, UPEC, Créteil, France.
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Previtali C, Sartoris R, Rebours V, Couvelard A, Cros J, Sauvanet A, Cauchy F, Paradis V, Vilgrain V, Dioguardi Burgio M, Ronot M. Quantitative imaging predicts pancreatic fatty infiltration on routine CT examination. Diagn Interv Imaging 2023; 104:359-367. [PMID: 37061392 DOI: 10.1016/j.diii.2023.03.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 04/17/2023]
Abstract
PURPOSE The purpose of this study was to assess the performance of quantitative computed tomography (CT) imaging for detecting pancreatic fatty infiltration, using the results of histopathological analysis as reference. MATERIALS AND METHODS Sixty patients who underwent pancreatic surgery for a pancreatic tumor between 2016 and 2019 were retrospectively included. There were 33 women and 27 men with a mean age of 56 ± 12 (SD) years (age range: 18-79 years). Patients with dilatation of the main pancreatic duct, chronic pancreatitis, or preoperative treatment were excluded to prevent any bias in the radiological-pathological correlation. Pancreatic fatty infiltration was recorded at pathology. Pancreatic surface lobularity, pancreatic attenuation, visceral fat area, and subcutaneous fat area were derived from preoperative CT images. The performance for the prediction of fatty infiltration was assessed using area under receiver operating characteristic curve (AUC) and backward binary logistic regression analysis. Results were validated in a separate cohort of 34 patients (17 women; mean age, 50 ± 14 [SD] years; age range: 18-73). RESULTS A total of 28/60 (47%) and 17/34 (50%) patients had pancreatic fatty infiltration in the derivation and validation cohorts, respectively. In the derivation cohort, patients with pancreatic fatty infiltration had a significantly higher PSL (P < 0.001) and a lower pancreatic attenuation on both precontrast and portal venous phase images (P = 0.011 and 0.003, respectively), and higher subcutaneous fat area and visceral fat area (P = 0.010 and 0.007, respectively). Multivariable analysis identified pancreatic surface lobularity > 7.6 and pancreatic attenuation on portal venous phase images < 83.5 Hounsfield units as independently associated with fatty infiltration. The combination of these variables resulted in an AUC of 0.85 (95% CI: 0.74-0.95) and 0.83 (95% CI: 0.67-0.99) in the derivation and validation cohorts, respectively. CONCLUSION CT-based quantitative imaging accurately predicts pancreatic fatty infiltration.
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Affiliation(s)
- Clelia Previtali
- Department of Radiology. APHP.Nord. Beaujon Hospital, 92118 Clichy, France
| | - Riccardo Sartoris
- Department of Radiology. APHP.Nord. Beaujon Hospital, 92118 Clichy, France; Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France
| | - Vinciane Rebours
- Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France; Department of Pancreatology. APHP.Nord. Beaujon Hospital, 92118 Clichy, France
| | - Anne Couvelard
- Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France; Department of Pathology. APHP.Nord. Bichat Hospital, 75018 Paris, France
| | - Jerome Cros
- Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France; Department of Pathology. APHP.Nord. Beaujon Hospital, 92118 Clichy, France
| | - Alain Sauvanet
- Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France; Department of Hepatobiliary Surgery. APHP.Nord. Beaujon Hospital, 92118 Clichy, France
| | - Francois Cauchy
- Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France; Department of Hepatobiliary Surgery. APHP.Nord. Beaujon Hospital, 92118 Clichy, France
| | - Valérie Paradis
- Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France; Department of Pathology. APHP.Nord. Bichat Hospital, 75018 Paris, France
| | - Valérie Vilgrain
- Department of Radiology. APHP.Nord. Beaujon Hospital, 92118 Clichy, France; Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France
| | - Marco Dioguardi Burgio
- Department of Radiology. APHP.Nord. Beaujon Hospital, 92118 Clichy, France; Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France
| | - Maxime Ronot
- Department of Radiology. APHP.Nord. Beaujon Hospital, 92118 Clichy, France; Universit éParis Cité, Centre de Recherche sur l'Inflammation, Inserm, U1149, 75006, Paris, France.
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Cannella R, Dioguardi Burgio M, Sartoris R, Gregory J, Vilgrain V, Ronot M. Adherence to LI-RADS and EASL high-risk population criteria: A systematic review. Hepatology 2023; 77:1958-1967. [PMID: 36811397 DOI: 10.1097/hep.0000000000000321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/08/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND AND AIMS The Liver Imaging Reporting and Data System (LI-RADS) and European Association for the Study of the Liver (EASL) diagnostic criteria for noninvasive diagnosis of HCC can only be applied to patients at a high risk of HCC. This systematic review assesses adherence to the LI-RADS and EASL high-risk population criteria in published studies. APPROACH AND RESULTS PubMed was searched for original research, published between January 2012 and December 2021, reporting LI-RADS and EASL diagnostic criteria on contrast-enhanced ultrasound, CT, or MRI. The algorithm version, publication year, risk status, and etiologies of chronic liver disease were recorded for each study. Adherence to high-risk population criteria was evaluated as optimal (unequivocal adherence), suboptimal (equivocal), or inadequate (clear violation). A total of 219 original studies were included, with 215 that used the LI-RADS criteria, 4 EASL only, and 15 that evaluated both LI-RADS and EASL criteria. Optimal, suboptimal, or inadequate adherence to high-risk population criteria was observed in 111/215 (51.6%), 86/215 (40.0%), and 18/215 (8.4%) LI-RADS and 6/19 (31.6%), 5/19 (26.3%), and 8/19 (42.1%) EASL studies ( p < 0.001) regardless of the imaging modality. Adherence to high-risk population criteria significantly improved according to the CT/MRI LI-RADS versions (optimal in v2018 in 64.5% of studies; v2017, 45.8%; v2014, 24.4%; v2013.1, 33.3%; p < 0.001) and the publication year (2020-2021, 62.5%; 2018-2019, 33.9%; 2014-2017, 39.3% of all LI-RADS studies; p = 0.002). No significant differences in adherence to high-risk population criteria were observed in the versions of contrast-enhanced ultrasound LI-RADS ( p = 0.388) or EASL ( p = 0.293). CONCLUSION Adherence to high-risk population criteria was optimal or suboptimal in about 90% and 60% of LI-RADS and EASL studies, respectively.
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Affiliation(s)
- Roberto Cannella
- Section of Radiology, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University Hospital "Paolo Giaccone", Via del Vespro, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine, and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
- Department of Radiology, Beaujon Hospital APHP.Nord, Clichy, France
| | | | | | - Jules Gregory
- Department of Radiology, Beaujon Hospital APHP.Nord, Clichy, France
- Université Paris Cité, CRI INSERM URM 1149, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Beaujon Hospital APHP.Nord, Clichy, France
- Université Paris Cité, CRI INSERM URM 1149, Paris, France
| | - Maxime Ronot
- Department of Radiology, Beaujon Hospital APHP.Nord, Clichy, France
- Université Paris Cité, CRI INSERM URM 1149, Paris, France
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Grégory J, Maino C, Vilgrain V, Ronot M, Boutron I. Completeness of reporting in abstracts of randomized controlled trials assessing interventional radiology for liver disease. J Vasc Interv Radiol 2023; 34:1576-1583.e7. [PMID: 37201657 DOI: 10.1016/j.jvir.2023.05.021] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/24/2023] [Accepted: 05/09/2023] [Indexed: 05/20/2023] Open
Abstract
PURPOSE To assess the completeness of reporting in abstracts of published randomized controlled trials (RCTs) assessing interventional radiology (IR) for liver disease; to assess whether publication of the 2017 CONSORT update for nonpharmacological treatments (NPT) resulted in changes in abstract reporting; and to identify factors associated with better reporting. MATERIAL AND METHODS MEDLINE and Embase were searched to identify RCTs of IR for liver disease (January 2015-September 2020). Two reviewers assessed the completeness of abstract reporting according to the CONSORT-NPT-2017-update. The primary outcome was the mean number of CONSORT items completely reported among 10 items reported in <50% of the abstracts published in 2015. A time series analysis assessed the evolution trend over time. A multivariate regression model was used to identify factors associated with better reporting. RESULTS A total of 107 abstracts of RCTs published in 61 journals were included. Overall, 74% (45/61) of journals endorsed the main CONSORT guidelines, of which 60% (27/45) had a policy to implement them. The mean number of primary outcome items completely reported increased by 0.19 over the study period. The publication of the CONSORT-NPT update did not lead to an increase in the trend of items reported (increase of 0.04 items/month before vs. 0.02 after, P=0.41). Factors associated with more complete reporting were impact factor (OR=1.13; 95%CI:1.07-1.18) and endorsement of CONSORT with an implementation policy (OR=8.29; 95%CI:2.04-33.65). CONCLUSION Completeness of reporting is incomplete in abstracts of trials of IR liver disease and did not improve after publication of the CONSORT-NPT-2017 update with abstract guidance.
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Affiliation(s)
- Jules Grégory
- Université Paris cité, INSERM, INRAE, CNAM, CRESS, Paris, France; Department of Radiology, APHP.Nord, Hôpital Beaujon, Clichy, France; FHU MOSAIC, APHP, Clichy, France.
| | - Cesare Maino
- Department of Radiology, APHP.Nord, Hôpital Beaujon, Clichy, France
| | - Valérie Vilgrain
- Department of Radiology, APHP.Nord, Hôpital Beaujon, Clichy, France; Laboratory of Imaging Biomarkers, INSERM U1149, Centre for Research on Inflammation, Paris, France
| | - Maxime Ronot
- Department of Radiology, APHP.Nord, Hôpital Beaujon, Clichy, France; Laboratory of Imaging Biomarkers, INSERM U1149, Centre for Research on Inflammation, Paris, France
| | - Isabelle Boutron
- Université Paris cité, INSERM, INRAE, CNAM, CRESS, Paris, France; Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, Paris, France
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Dana J, Debray D, Vilgrain V. Reply to: "The effects of CFTR modulator therapies on liver stiffness and bile flow: a single centre experience". J Hepatol 2023:S0168-8278(23)00222-2. [PMID: 37044220 DOI: 10.1016/j.jhep.2023.04.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Affiliation(s)
- Jérémy Dana
- Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Canada; Université de Strasbourg, Strasbourg, France; Inserm, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France; IHU-Strasbourg (Institut Hospitalo-Universitaire), Pôle Hépato-digestif, Nouvel Hôpital Civil, Strasbourg, France.
| | - Dominique Debray
- Department of Pediatric Hepatology, Necker-Enfants Malades Hospital, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France; Necker-Enfants Malades Institute, Inserm U1121, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, Beaujon Hospital, Université de Paris, Clichy, France
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Valainathan SR, Ronot M, Vilgrain V, Rautou PE. Reply. Hepatology 2023; 77:E72-E73. [PMID: 36626625 DOI: 10.1097/hep.0000000000000022] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Shantha Ram Valainathan
- Inserm, Centre de recherche sur l'inflammation, Université Paris-Cité, Paris, France
- Service d'Hépatologie, AP-HP, Hôpital Beaujon, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Clichy, France
| | - Maxime Ronot
- Inserm, Centre de recherche sur l'inflammation, Université Paris-Cité, Paris, France
- Service d'imagerie Médicale, AP-HP, Hôpital Beaujon, Clichy, France
| | - Valérie Vilgrain
- Inserm, Centre de recherche sur l'inflammation, Université Paris-Cité, Paris, France
- Service d'imagerie Médicale, AP-HP, Hôpital Beaujon, Clichy, France
| | - Pierre-Emmanuel Rautou
- Inserm, Centre de recherche sur l'inflammation, Université Paris-Cité, Paris, France
- Service d'Hépatologie, AP-HP, Hôpital Beaujon, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Clichy, France
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Vanderbecq Q, Grégory J, Dana J, Dioguardi Burgio M, Garzelli L, Raynaud L, Frémy S, Paulatto L, Bouattour M, Kavafyan-Lasserre J, Vilgrain V, Ronot M. Improving pain control during transarterial chemoembolization for hepatocellular carcinoma performed under local anesthesia with multimodal analgesia. Diagn Interv Imaging 2023; 104:123-132. [PMID: 36805801 DOI: 10.1016/j.diii.2022.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/28/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study was to assess the performance of a reinforced analgesic protocol (RAP) on pain control in patients undergoing conventional trans-arterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS Eighty-one consecutive patients (57 men, 24 women) with a mean age of 69 ± 10 (standard deviation) years (age range: 49-92 years) underwent 103 cTACEs. Standard antalgic protocol (50 mg hydroxyzine, 10 mg oxycodone, 8 mg ondansetron, and lidocaine for local anesthesia) was prospectively compared to a RAP (standard + 40 mg 2-h infusion nefopam and 50 mg tramadol). The individual pain risk was stratified based on age, the presence of cirrhosis and alcoholic liver disease, and patients were assigned to a low-risk group (standard protocol) or high-risk group (RAP). The primary endpoint was severe periprocedural abdominal pain (SAP), defined as a visual analog scale score ≥30/100. A predefined intermediate analysis was performed to monitor the benefit-risk of the RAP. Based on the intermediate analysis, all patients were treated with the RAP. RESULTS The intermediate analysis performed after 52 cTACE showed that 2/17 (12%) high-risk patients (i.e., those receiving the RAP) experienced SAP compared to 15/35 (43%) low-risk patients (odds ratio [OR] = 0.18; 95% confidence interval [CI]: 0.02-0.98; P = 0.03). Analysis of all procedures showed that 12/67 (18%) patients in cTACE receiving the RAP experienced SAP compared to 15/36 (42%) patients who did not receive it (OR = 3.27; 95% CI: 1.32-8.14; P = 0.01). There were no statistical differences in adverse events, particularly for nausea, between groups. CONCLUSION Reinforcing the analgesic protocol by combining non-opioid and opioid molecules reduces perioperative pain in patients undergoing cTACE for HCC.
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Affiliation(s)
- Quentin Vanderbecq
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France
| | - Jules Grégory
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France; Université Paris Cité, INSERM U1149, "Centre de Recherche sur l'Inflammation", CRI, 75018 Paris, France; FHU MOSAIC, 92110 Clichy, France
| | - Jeremy Dana
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France; Université Paris Cité, INSERM U1149, "Centre de Recherche sur l'Inflammation", CRI, 75018 Paris, France
| | - Lorenzo Garzelli
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France; Université Paris Cité, INSERM U1149, "Centre de Recherche sur l'Inflammation", CRI, 75018 Paris, France
| | - Lucas Raynaud
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France
| | - Sébastien Frémy
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France
| | - Luisa Paulatto
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France
| | | | | | - Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France; Université Paris Cité, INSERM U1149, "Centre de Recherche sur l'Inflammation", CRI, 75018 Paris, France
| | - Maxime Ronot
- Department of Radiology, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France; Université Paris Cité, INSERM U1149, "Centre de Recherche sur l'Inflammation", CRI, 75018 Paris, France; Department of Anesthesiology and Intensive Care, Hôpital Beaujon, AP-HP.Nord, 92110 Clichy, France.
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Garzelli L, Felli E, Al-Taher M, Barberio M, Agnus V, Plaforet V, Bonvalet F, Baiocchini A, Nuzzo A, Paulatto L, Vilgrain V, Gallix B, Diana M, Ronot M. MRI for the Detection of Small Bowel Ischemic Injury in Arterial Acute Mesenteric Ischemia: Preclinical Study in a Porcine Model. J Magn Reson Imaging 2023; 57:918-927. [PMID: 35852296 DOI: 10.1002/jmri.28344] [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: 12/08/2021] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND MRI is the reference for the diagnosis of arterial cerebral ischemia, but its role in acute mesenteric ischemia (AMI) is poorly known. PURPOSE To assess MRI detection of early ischemic bowel lesions in a porcine model of arterial AMI. STUDY TYPE Prospective/cohort. ANIMAL MODEL Porcine model of arterial AMI obtained by embolization of the superior mesenteric artery (seven pigs). FIELD STRENGTH/SEQUENCE A 5-T. T1 gradient-echo-weighted-imaging (WI), half-Fourier-acquisition-single-shot-turbo-spin-echo, T2 turbo-spin-echo, true-fast-imaging-with-steady-precession (True-FISP), diffusion-weighted-echo-planar (DWI). ASSESSMENT T1-WI, T2-WI, and DWI were performed before and continuously after embolization for 6 hours. The signal intensity (SI) of the ischemic bowel was assessed visually and quantitatively on all sequences. The apparent diffusion coefficient (ADC) was assessed. STATISTICAL TESTS Paired Student's t-test or Mann-Whitney U-test, significance at P < 0.05. RESULTS One pig died from non-AMI-related causes. The remaining pigs underwent a median 5 h53 (range 1 h24-6 h01) of ischemia. Visually, the ischemic bowel showed signal hyperintensity on DWI-b800 after a median 85 (57-276) minutes compared to the nonischemic bowel. DWI-b800 SI significantly increased after 2 hours (+19%) and the ADC significant decrease within the first hour (-31%). The ischemic bowel was hyperintense on precontrast T1-WI after a median 87 (70-171) minutes with no significant quantitative changes over time (P = 0.46-0.93). The ischemic bowel was hyperintense on T2-WI in three pigs with a significant SI increase on True-FISP after 1 and 2 hours. DATA CONCLUSION Changes in SI and ADC can be seen early after the onset of arterial AMI with DWI. The value of T2-WI appears to be limited. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Lorenzo Garzelli
- Université Paris Cité, Paris, France & Department of Radiology, Beaujon Hospital, APHP.Nord, Clichy, France.,IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France
| | - Eric Felli
- IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France.,Hepatology, Department of Biomedical Research, Inselspital, University of Bern, Bern, Switzerland
| | - Mahdi Al-Taher
- IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France
| | - Manuel Barberio
- IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France
| | - Vincent Agnus
- IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France
| | - Vincent Plaforet
- Université Paris Cité, Paris, France & Department of Radiology, Beaujon Hospital, APHP.Nord, Clichy, France
| | - Fanny Bonvalet
- Université Paris Cité, Paris, France & Department of Radiology, Beaujon Hospital, APHP.Nord, Clichy, France
| | - Andrea Baiocchini
- Department of Pathology, San Camillo Forlanini Hospital, Rome, Italy
| | - Alexandre Nuzzo
- Université Paris Cité, Paris, France & Structure d'Urgence Vasculaire Intestinales (SURVI), Nutritional support, Gastroenterology, Beaujon Hospital, APHP.Nord, Clichy, France
| | - Luisa Paulatto
- Université Paris Cité, Paris, France & Department of Radiology, Beaujon Hospital, APHP.Nord, Clichy, France
| | - Valérie Vilgrain
- Université Paris Cité, Paris, France & Department of Radiology, Beaujon Hospital, APHP.Nord, Clichy, France
| | - Benoit Gallix
- IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France
| | - Michele Diana
- IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France.,IRCAD, Research Institute against Digestive Cancer, Strasbourg, France.,Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg, France.,ICube Lab, Photonics for Health, Strasbourg, France
| | - Maxime Ronot
- Université Paris Cité, Paris, France & Department of Radiology, Beaujon Hospital, APHP.Nord, Clichy, France
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Gregory J, Tselikas L, Allimant C, de Baere T, Bargellini I, Bell J, Bilbao JI, Bouvier A, Chapiro J, Chiesa C, Decaens T, Denys A, Duran R, Edeline J, Garin E, Ghelfi J, Helmberger T, Irani F, Lam M, Lewandowski R, Liu D, Loffroy R, Madoff DC, Mastier C, Salem R, Sangro B, Sze D, Vilgrain V, Vouche M, Guiu B, Ronot M. Defining textbook outcome for selective internal radiation therapy of hepatocellular carcinoma: an international expert study. Eur J Nucl Med Mol Imaging 2023; 50:921-928. [PMID: 36282299 DOI: 10.1007/s00259-022-06002-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 05/24/2022] [Accepted: 10/09/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND A textbook outcome (TO) is a composite indicator covering the entire intervention process in order to reflect the "ideal" intervention and be a surrogate for patient important outcomes. Selective internal radiation therapy (SIRT) is a complex multidisciplinary and multistep intervention facing the challenge of standardization. This expert opinion-based study aimed to define a TO for SIRT of hepatocellular carcinoma. METHODS This study involved two steps: (1) the steering committee (4 interventional radiologists) first developed an extensive list of possible relevant items reflecting an optimal SIRT intervention based on a literature review and (2) then conducted an international and multidisciplinary survey which resulted in the final TO. This survey was online, from February to July 2021, and consisted three consecutive rounds with predefined settings. Experts were identified by contacting senior authors of randomized trials, large observational studies, or studies on quality improvement in SIRT. This study was strictly academic. RESULTS A total of 50 items were included in the first round of the survey. A total of 29/40 experts (73%) responded, including 23 interventional radiologists (79%), three nuclear medicine physicians (10%), two hepatologists, and one oncologist, from 11 countries spanning three continents. The final TO consisted 11 parameters across six domains ("pre-intervention workup," "tumor targeting and dosimetry," "intervention," "post-90Y imaging," "length of hospital stay," and "complications"). Of these, all but one were applied in the institutions of > 80% of experts. CONCLUSIONS This multidimensional indicator is a comprehensive standardization tool, suitable for routine care, clinical round, and research.
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Affiliation(s)
- Jules Gregory
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France. .,Department of Radiology, APHP Nord, Hôpital Beaujon, Clichy, France. .,FHU MOSAIC, APHP, Paris, France. .,Centre of Research in Epidemiology and Statistics (CRESS), Université Paris Cité, Inserm, INRAE, Paris, France.
| | | | | | | | | | - Jon Bell
- The Christie National Health Service Foundation Trust, Manchester, UK
| | | | | | | | - Carlo Chiesa
- Foundation IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | | | | | | | | | | | | | - Farah Irani
- Singapore General Hospital, Singapore, Singapore
| | - Marnix Lam
- University Medical Center, Utrecht, Netherlands
| | | | - David Liu
- Vancouver General Hospital, Vancouver, Canada
| | | | | | | | - Riad Salem
- Northwestern Memorial Hospital, Chicago, USA
| | - Bruno Sangro
- Clínica Universidad de Navarra-CCUN and CIBEREHD, Pamplona, Spain
| | | | - Valérie Vilgrain
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France.,Department of Radiology, APHP Nord, Hôpital Beaujon, Clichy, France
| | - Michael Vouche
- Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium
| | | | - Maxime Ronot
- Centre de Recherche de L'Inflammation (CRI), Université Paris Cité, INSERM U1149, Paris, France.,Department of Radiology, APHP Nord, Hôpital Beaujon, Clichy, France
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Demory A, Péron JM, Calderaro J, Selves J, Mokrane FZ, Amaddeo G, Paradis V, Ziol M, Sutter O, Blaise L, Ganne-Carrié N, Vilgrain V, Cauchy F, Zucman-Rossi J, Ronot M, Nault JC. Body weight changes and duration of estrogen exposure modulate the evolution of hepatocellular adenomas after contraception discontinuation. Hepatology 2023; 77:430-442. [PMID: 35980227 DOI: 10.1002/hep.32734] [Citation(s) in RCA: 2] [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: 06/01/2022] [Revised: 07/28/2022] [Accepted: 08/05/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS The natural history of hepatocellular adenomas (HCAs) remains to be better described, especially in nonresected patients. We aim to identify the predictive factors of HCA evolution after estrogen-based contraception discontinuation. APPROACH AND RESULTS We retrospectively included patients with a histological diagnosis of HCA from three centers. Clinical, radiological, and pathological data were collected to identify predictive factors of radiological evolution per Response Evaluation Criteria in Solid Tumors, version 1.1, and occurrence of complications (bleeding, malignant transformation). We built a score using variables that modulate estrogen levels: body mass index and duration of estrogen-based contraception. An external cohort was used to validate this score. 183 patients were included in the cohort, including 161 women (89%) using estrogen-based contraception for a median of 12 years. Thirty percent of patients had at least one HNF1A -inactivated HCA, 45.5% at least one inflammatory HCA, and 11% at least one HCA with activation of β-catenin (bHCA). Twenty-one symptomatic bleedings (11%) and eleven malignant transformations (6%) occurred. Ages < 37 years old ( p = 0.004) and HCA > 5 cm at imaging were independently associated with symptomatic bleeding ( p = 0.003), whereas a bHCA was associated with malignant transformation ( p < 0.001). After a median follow-up of 5 years, radiological regression was observed in 31%, stabilization in 47%, and progression in 22% of patients. Weight loss was associated with regression ( p < 0.0001) and weight gain with progression ( p = 0.02). The estrogen exposure score predicted radiological regression (odds ratio, 2.33; confidence interval 95%, 1.29-4.19; p = 0.005) with a linear relationship between the rate of estrogen exposure and the probability of regression. This result was confirmed in an external cohort of 72 female patients ( p = 0.003). CONCLUSION Weight variation is strongly associated with radiological evolution after oral contraception discontinuation. A score of estrogen exposure, easily assessable in clinical practice at diagnosis, predicts regression of HCA.
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Affiliation(s)
- Alix Demory
- Service d'hépatologie , Hôpital Avicenne , Hôpitaux Universitaires Paris-Seine-Saint-Denis , Assistance-Publique-Hôpitaux de Paris , Bobigny , France.,Unité de Formation et de Recherche Santé Médecine et Biologie Humaine , Université Paris Nord , Paris , France.,Centre de Recherche des Cordeliers , Inserm, Sorbonne Université, Université Paris, INSERM, Functional Genomics of Solid Tumors laboratory , Paris , France
| | - Jean-Marie Péron
- Service d'hépatogastroentérologie , hôpital Rangueil , CHU Toulouse Assistance , Toulouse , France
| | - Julien Calderaro
- Department of Pathology , Publique-Hôpitaux de Paris , Henri Mondor-Albert Chenevier University Hospital , Créteil , France.,Université Paris Est Créteil , INSERM, IMRB , Créteil , France.,INSERM, Unit U955, Team 18 , Créteil , France
| | - Janick Selves
- Service d'anatomopathologie , hôpital Rangueil , CHU Toulouse Assistance , Toulouse , France
| | - Fatima-Zohra Mokrane
- Service de radiologie , hôpital Rangueil , CHU Toulouse Assistance , Toulouse , France
| | - Giuliana Amaddeo
- Assistance Publique-Hôpitaux de Paris , Hôpital Henri Mondor, Service d'Hépatologie , Créteil , France.,Université Paris Est Créteil, INSERM, IMRB , Créteil , France.,INSERM, U955, Equipe 18 "Physiopathologie et Thérapeutiques des Hépatites Virales Chroniques et des cancers liés" , Créteil , France
| | - Valérie Paradis
- Assistance Publique-Hôpitaux de Paris , Hôpital Beaujon, Service d'anatomopathologie , Clichy , France.,Université de Paris Cité, Centre de recherche sur l'inflammation, Inserm, U1149, CNRS, ERL8252 , Paris , France
| | - Marianne Ziol
- Unité de Formation et de Recherche Santé Médecine et Biologie Humaine , Université Paris Nord , Paris , France.,Centre de Recherche des Cordeliers , Inserm, Sorbonne Université, Université Paris, INSERM, Functional Genomics of Solid Tumors laboratory , Paris , France.,Service d'anatomopathologie , Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique-Hôpitaux de Paris , Bobigny , France
| | - Olivier Sutter
- Service de radiologie , Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique-Hôpitaux de Paris , Bobigny , France
| | - Lorraine Blaise
- Service d'hépatologie , Hôpital Avicenne , Hôpitaux Universitaires Paris-Seine-Saint-Denis , Assistance-Publique-Hôpitaux de Paris , Bobigny , France
| | - Nathalie Ganne-Carrié
- Service d'hépatologie , Hôpital Avicenne , Hôpitaux Universitaires Paris-Seine-Saint-Denis , Assistance-Publique-Hôpitaux de Paris , Bobigny , France.,Unité de Formation et de Recherche Santé Médecine et Biologie Humaine , Université Paris Nord , Paris , France.,Centre de Recherche des Cordeliers , Inserm, Sorbonne Université, Université Paris, INSERM, Functional Genomics of Solid Tumors laboratory , Paris , France
| | - Valérie Vilgrain
- Assistance Publique-Hôpitaux de Paris , Hôpital Beaujon, Service de radiologie , Clichy , France.,INSERM U1149 "Centre de Recherche Sur L'inflammation" , CRI, Université Paris Cité , Paris , France
| | - François Cauchy
- INSERM U1149 "Centre de Recherche Sur L'inflammation" , CRI, Université Paris Cité , Paris , France.,Assistance Publique-Hôpitaux de Paris , Hôpital Beaujon, Service de chirurgie hépato-biliaire , Clichy , France
| | - Jessica Zucman-Rossi
- Centre de Recherche des Cordeliers , Inserm, Sorbonne Université, Université Paris, INSERM, Functional Genomics of Solid Tumors laboratory , Paris , France.,Assistance Publique-Hôpitaux de Paris , Service d'Oncologie Médicale, Hôpital Européen Georges Pompidou , Paris , France
| | - Maxime Ronot
- Assistance Publique-Hôpitaux de Paris , Hôpital Beaujon, Service de radiologie , Clichy , France.,INSERM U1149 "Centre de Recherche Sur L'inflammation" , CRI, Université Paris Cité , Paris , France
| | - Jean-Charles Nault
- Service d'hépatologie , Hôpital Avicenne , Hôpitaux Universitaires Paris-Seine-Saint-Denis , Assistance-Publique-Hôpitaux de Paris , Bobigny , France.,Unité de Formation et de Recherche Santé Médecine et Biologie Humaine , Université Paris Nord , Paris , France.,Centre de Recherche des Cordeliers , Inserm, Sorbonne Université, Université Paris, INSERM, Functional Genomics of Solid Tumors laboratory , Paris , France
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Couteaux V, Zhang C, Mulé S, Milot L, Valette PJ, Raynaud C, Vlachomitrou AS, Ciofolo-Veit C, Lawrance L, Belkouchi Y, Vilgrain V, Lewin M, Trillaud H, Hoeffel C, Laurent V, Ammari S, Morand E, Faucoz O, Tenenhaus A, Talbot H, Luciani A, Lassau N, Lazarus C. Synthetic MR image generation of macrotrabecular-massive hepatocellular carcinoma using generative adversarial networks. Diagn Interv Imaging 2023; 104:243-247. [PMID: 36681532 DOI: 10.1016/j.diii.2023.01.003] [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: 10/20/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE The purpose of this study was to develop a method for generating synthetic MR images of macrotrabecular-massive hepatocellular carcinoma (MTM-HCC). MATERIALS AND METHODS A set of abdominal MR images including fat-saturated T1-weighted images obtained during the arterial and portal venous phases of enhancement and T2-weighted images of 91 patients with MTM-HCC, and another set of MR abdominal images from 67 other patients were used. Synthetic images were obtained using a 3-step pipeline that consisted in: (i), generating a synthetic MTM-HCC tumor on a neutral background; (ii), randomly selecting a background among the 67 patients and a position inside the liver; and (iii), merging the generated tumor in the background at the specified location. Synthetic images were qualitatively evaluated by three radiologists and quantitatively assessed using a mix of 1-nearest neighbor classifier metric and Fréchet inception distance. RESULTS A set of 1000 triplets of synthetic MTM-HCC images with consistent contrasts were successfully generated. Evaluation of selected synthetic images by three radiologists showed that the method gave realistic, consistent and diversified images. Qualitative and quantitative evaluation led to an overall score of 0.64. CONCLUSION This study shows the feasibility of generating realistic synthetic MR images with very few training data, by leveraging the wide availability of liver backgrounds. Further studies are needed to assess the added value of those synthetic images for automatic diagnosis of MTM-HCC.
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Affiliation(s)
| | - Cheng Zhang
- Philips Research France, 92150 Suresnes, France
| | - Sébastien Mulé
- Medical Imaging Department, AP-HP, Henri Mondor University Hospital, 94000 Créteil, France; INSERM, U955, Team 18, 94000 Créteil, France
| | - Laurent Milot
- Body and VIR Radiology Department, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69003 Lyon, France
| | - Pierre-Jean Valette
- Body and VIR Radiology Department, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69003 Lyon, France
| | | | | | | | - Littisha Lawrance
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, BIOMAPS, UMR 1281, Université Paris-Saclay, Inserm, CNRS, CEA, 94800 Villejuif, France
| | - Younes Belkouchi
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, BIOMAPS, UMR 1281, Université Paris-Saclay, Inserm, CNRS, CEA, 94800 Villejuif, France; OPIS - Optimisation Imagerie et Santé, Université Paris-Saclay, Inria, CentraleSupélec, CVN - Centre de vision numérique, 91190 Gif-Sur-Yvette, France
| | - Valérie Vilgrain
- Department of Radiology, APHP, University Hospitals Paris Nord-Val de Seine, Hôpital Beaujon, 92210 Clichy, France; Université Paris Cité, CRI INSERM, 75006 Paris, France
| | - Maité Lewin
- Department of Radiology, AP-HP Hôpital Paul Brousse, 94800 Villejuif, France; Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - Hervé Trillaud
- CHU de Bordeaux, Department of Radiology, Université de Bordeaux, F-33000 Bordeaux, France
| | - Christine Hoeffel
- Department of Radiology, Reims University Hospital, 51092 Reims, France; CRESTIC, University of Reims Champagne-Ardenne, 51100 Reims, France
| | - Valérie Laurent
- Department of Radiology, Nancy University Hospital, University of Lorraine, 54500 Vandoeuvre-lès-Nancy, France
| | - Samy Ammari
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, BIOMAPS, UMR 1281, Université Paris-Saclay, Inserm, CNRS, CEA, 94800 Villejuif, France; Department of Imaging, Institut Gustave Roussy, Université Paris-Saclay, 94800 Villejuif, France
| | - Eric Morand
- Centre National d'Etudes Spatiales, Centre Spatial de Toulouse, 31000 Toulouse, France
| | - Orphee Faucoz
- Centre National d'Etudes Spatiales, Centre Spatial de Toulouse, 31000 Toulouse, France
| | - Arthur Tenenhaus
- Université Paris-Saclay, Centrale Supélec, Laboratoire des Signaux et Systèmes, 91190 Gif-sur-Yvette, France
| | - Hugues Talbot
- OPIS - Optimisation Imagerie et Santé, Université Paris-Saclay, Inria, CentraleSupélec, CVN - Centre de vision numérique, 91190 Gif-Sur-Yvette, France
| | - Alain Luciani
- Medical Imaging Department, AP-HP, Henri Mondor University Hospital, 94000 Créteil, France; INSERM, U955, Team 18, 94000 Créteil, France
| | - Nathalie Lassau
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, BIOMAPS, UMR 1281, Université Paris-Saclay, Inserm, CNRS, CEA, 94800 Villejuif, France; Department of Imaging, Institut Gustave Roussy, Université Paris-Saclay, 94800 Villejuif, France
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Renard AS, Paisant A, Cartier V, Calès P, Goyet-Prelipcean M, Geagea E, Tasu JP, Silvain C, Wagner M, Cleach AL, Vilgrain V, Castera L, Bricault I, Decaens T, Savoye-Collet C, Montialoux H, Correas JM, Vallet-Pichard A, Boursier J, Aubé C. Validation of a screening algorithm for hepatic fibrosis by Doppler ultrasound and elastography in a general population. Acta Radiol 2023; 64:1730-1737. [PMID: 36617943 DOI: 10.1177/02841851221138519] [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] [Indexed: 01/10/2023]
Abstract
BACKGROUND Early detection can prevent the initial stages of fibrosis from progressing to cirrhosis. PURPOSE To evaluate an algorithm combining three echographic indicators and elastographic measurements to screen for hepatic fibrosis in an unselected population. MATERIAL AND METHODS From May 2017 to June 2018, all patients with no history and no known chronic liver disease who were referred for an ultrasound (US) were prospectively included in eight hospitals. The indicators being sought were liver surface irregularity, demodulation of hepatic veins, and spleen length >110 mm. Patients presenting at least one of these underwent elastography measurements with virtual touch quantification (VTQ) or supersonic shear imaging (SSI). If elastography was positive, patients were referred to hepatologist for fibrosis evaluation. Reference standard was obtained by FibroMeterVCTE or biopsy. A FibroMeterVCTE result >0.384 indicated a "necessary referral" to a hepatologist. RESULTS Of the 1501 patients included, 504 (33.6%) were positive for at least one US indicator. All of them underwent US elastography, with 85 being positive. Of the patients, 58 (3.6%) had a consultation with a liver specialist: 21 had positive FibroMeterVCTE and nine had an indication of biopsy for suspicion of fibrosis. This screening algorithm made it possible to diagnose 1.6% of patients in our population with unknown fibrosis. Of the patients, 50% referred to the liver specialist were "necessary referrals." CONCLUSION Our study suggests that three simple US indicators with no systematic elastographic measurement could be applied in day-to-day practice to look for hepatic fibrosis in an unsuspected population allowing relevant referrals to a hepatologist.
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Affiliation(s)
| | - Anita Paisant
- Department of Radiology, Angers University Hospital, Angers, France.,HIFIH Laboratory, EA 3859, UNIV Angers, Angers, France
| | - Victoire Cartier
- Department of Radiology, Angers University Hospital, Angers, France
| | - Paul Calès
- HIFIH Laboratory, EA 3859, UNIV Angers, Angers, France.,Department of Hepatology, Angers University Hospital, Angers, France
| | | | - Edmond Geagea
- Department of Hepatology, Cholet Hospital, Cholet, France
| | | | | | - Mathilde Wagner
- UPMC, Department of Radiology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, Paris, France
| | - Aline Le Cleach
- UPMC, Department of Hepatology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, Paris, France
| | - Valérie Vilgrain
- Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.,University Paris Diderot. Sorbonne Paris Cité, INSERM U1149, CRI, Paris, France
| | - Laurent Castera
- Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
| | - Ivan Bricault
- Department of Radiology and Medical Imaging, University Hospital, Grenoble, France.,Laboratory of Techniques for Biomedical Engineering and Complexity Management, University Grenoble Alpes / National Center for Scientific Research, Grenoble, France.,Clinical Investigation Center - Innovative Technology 1406, National Institute of Health and Medical Research / Research Department, University Hospital, Grenoble, France
| | - Thomas Decaens
- Université Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences, Research Center UGA/Inserm U 1209/CNRS 5309, La Tronche, France.,Department of Hepatology, Pôle Digidune, CHU Grenoble Alpes, La Tronche, France
| | - Céline Savoye-Collet
- Department of Radiology, Rouen University Hospital, Normandie Univ, UNIROUEN, Quantif-LITIS EA 4108, Rouen cedex, France
| | - Hélène Montialoux
- Department of Hepatology, Rouen University Hospital, Rouen cedex, France
| | - Jean-Michel Correas
- Department of Adult Radiology, Hôpital Necker, Université Paris Descartes, Paris, France
| | - Anaïs Vallet-Pichard
- Department of Hepatology, AP-HP, université Paris Descartes, Sorbonne Paris Cité, groupe hospitalier Cochin Port Royal, Paris, France.,Institut Pasteur, U.1223, Inserm, Paris, France
| | - Jérôme Boursier
- HIFIH Laboratory, EA 3859, UNIV Angers, Angers, France.,Department of Hepatology, Angers University Hospital, Angers, France
| | - Christophe Aubé
- Department of Radiology, Angers University Hospital, Angers, France.,HIFIH Laboratory, EA 3859, UNIV Angers, Angers, France
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Assouline J, Cannella R, Porrello G, de Mestier L, Dioguardi Burgio M, Raynaud L, Hentic O, Cros J, Tselikas L, Ruszniewski P, Vullierme MP, Vilgrain V, Duran R, Ronot M. Volumetric Enhancing Tumor Burden at CT to Predict Survival Outcomes in Patients with Neuroendocrine Liver Metastases after Intra-arterial Treatment. Radiol Imaging Cancer 2023; 5:e220051. [PMID: 36607243 PMCID: PMC9896229 DOI: 10.1148/rycan.220051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose To investigate whether liver enhancing tumor burden (LETB) assessed at contrast-enhanced CT indicates early response and helps predict survival outcomes in patients with multifocal neuroendocrine liver metastases (NELM) after intra-arterial treatment. Materials and Methods This retrospective study included patients with NELM who underwent intra-arterial treatment with transarterial embolization (TAE) or chemoembolization (TACE) between April 2006 and December 2018. Tumor response in treated NELM was evaluated by using the Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST). LETB was measured as attenuation 2 SDs greater than that of a region of interest in the nontumoral liver parenchyma. Overall survival (OS); time to unTA(C)Eable progression, defined as the time from the initial treatment until the time when intra-arterial treatments were considered technically unfeasible, either not recommended by the multidisciplinary tumor board or until death; and hepatic and whole-body progression-free survival (PFS) were evaluated using multivariable Cox proportional hazards analyses, the Kaplan-Meier method, and log-rank test. Results The study included 119 patients (mean age, 60 years ± 11 [SD]; 61 men) who underwent 161 treatments. A median LETB change of -25.8% best discriminated OS (83 months in responders vs 51 months in nonresponders; P = .02) and whole-body PFS (18 vs 8 months, respectively; P < .001). A -10% LETB change best discriminated time to unTA(C)Eable progression (32 months in responders vs 12 months in nonresponders; P < .001) and hepatic PFS (18 vs 8 months, respectively; P < .001). LETB change remained independently associated with improved OS (hazard ratio [HR], 0.56), time to unTA(C)Eable progression (HR, 0.44), hepatic PFS (HR, 0.42), and whole-body PFS (HR, 0.47) on multivariable analysis. Neither RECIST nor mRECIST helped predict patient outcome. Conclusion Response according to LETB change helped predict survival outcomes in patients with NELM after intra-arterial treatments, with better discrimination than RECIST and mRECIST. Keywords: CT, Chemoembolization, Embolization, Abdomen/GI, Liver Supplemental material is available for this article. © RSNA, 2023.
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Mulé S, Lawrance L, Belkouchi Y, Vilgrain V, Lewin M, Trillaud H, Hoeffel C, Laurent V, Ammari S, Morand E, Faucoz O, Tenenhaus A, Cotten A, Meder JF, Talbot H, Luciani A, Lassau N. Generative adversarial networks (GAN)-based data augmentation of rare liver cancers: The SFR 2021 Artificial Intelligence Data Challenge. Diagn Interv Imaging 2023; 104:43-48. [PMID: 36207277 DOI: 10.1016/j.diii.2022.09.005] [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: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE The 2021 edition of the Artificial Intelligence Data Challenge was organized by the French Society of Radiology together with the Centre National d'Études Spatiales and CentraleSupélec with the aim to implement generative adversarial networks (GANs) techniques to provide 1000 magnetic resonance imaging (MRI) cases of macrotrabecular-massive (MTM) hepatocellular carcinoma (HCC), a rare and aggressive subtype of HCC, generated from a limited number of real cases from multiple French centers. MATERIALS AND METHODS A dedicated platform was used by the seven inclusion centers to securely upload their anonymized MRI examinations including all three cross-sectional images (one late arterial and one portal-venous phase T1-weighted images and one fat-saturated T2-weighted image) in compliance with general data protection regulation. The quality of the database was checked by experts and manual delineation of the lesions was performed by the expert radiologists involved in each center. Multidisciplinary teams competed between October 11th, 2021 and February 13th, 2022. RESULTS A total of 91 MTM-HCC datasets of three images each were collected from seven French academic centers. Six teams with a total of 28 individuals participated in this challenge. Each participating team was asked to generate one thousand 3-image cases. The qualitative evaluation was performed by three radiologists using the Likert scale on ten randomly selected cases generated by each participant. A quantitative evaluation was also performed using two metrics, the Frechet inception distance and a leave-one-out accuracy of a 1-Nearest Neighbor algorithm. CONCLUSION This data challenge demonstrates the ability of GANs techniques to generate a large number of images from a small sample of imaging examinations of a rare malignant tumor.
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Affiliation(s)
- Sébastien Mulé
- Medical Imaging Department, AP-HP, Henri Mondor University Hospital, Créteil 94000, France; INSERM, U955, Team 18, Créteil 94000, France.
| | - Littisha Lawrance
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, Inserm, CNRS, CEA, BIOMAPS, UMR 1281, Université Paris-Saclay, Villejuif 94800, France
| | - Younes Belkouchi
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, Inserm, CNRS, CEA, BIOMAPS, UMR 1281, Université Paris-Saclay, Villejuif 94800, France; OPIS-Optimisation Imagerie et Santé, Inria, CentraleSupélec, CVN-Centre de Vision Numérique, Université Paris-Saclay, Gif-Sur-Yvette 91190, France
| | - Valérie Vilgrain
- Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy 92110, France; CRI INSERM, Université Paris Cité, Paris 75018, France
| | - Maité Lewin
- Department of Radiology, AP-HP Hôpital Paul Brousse, Villejuif 94800, France; Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre 94270, France
| | - Hervé Trillaud
- CHU de Bordeaux, Department of Radiology, Université de Bordeaux, Bordeaux 33000, France
| | - Christine Hoeffel
- Department of Radiology, Reims University Hospital, Reims 51092, France; CRESTIC, University of Reims Champagne-Ardenne, Reims 51100, France
| | - Valérie Laurent
- Department of Radiology, Nancy University Hospital, University of Lorraine, Vandoeuvre-ls-Nancy 54500, France
| | - Samy Ammari
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, Inserm, CNRS, CEA, BIOMAPS, UMR 1281, Université Paris-Saclay, Villejuif 94800, France; Department of Imaging, Institut Gustave Roussy, Université Paris-Saclay, Villejuif 94800, France
| | - Eric Morand
- Centre National d'Etudes Spatiales-CNES, Centre Spatial de Toulouse, Toulouse 31401 CEDEX 9 University, France
| | - Orphée Faucoz
- Centre National d'Etudes Spatiales-CNES, Centre Spatial de Toulouse, Toulouse 31401 CEDEX 9 University, France
| | - Arthur Tenenhaus
- CentraleSupélec, Laboratoire des Signaux et Systèmes, Université Paris-Saclay, Gif-sur-Yvette 91190, France
| | - Anne Cotten
- Department of Musculoskeletal Radiology, Centre de Consultations Et D'imagerie de L'appareil Locomoteur, Lille 59037, France; Lille University School of Medicine, Lille, France
| | - Jean-François Meder
- Department of Neuroimaging, Sainte-Anne Hospital, Paris 75013 University, France; Université Paris Cité, Paris 75006, France
| | - Hugues Talbot
- OPIS-Optimisation Imagerie et Santé, Inria, CentraleSupélec, CVN-Centre de Vision Numérique, Université Paris-Saclay, Gif-Sur-Yvette 91190, France
| | - Alain Luciani
- Medical Imaging Department, AP-HP, Henri Mondor University Hospital, Créteil 94000, France; INSERM, U955, Team 18, Créteil 94000, France
| | - Nathalie Lassau
- Laboratoire d'Imagerie Biomédicale Multimodale Paris-Saclay, Inserm, CNRS, CEA, BIOMAPS, UMR 1281, Université Paris-Saclay, Villejuif 94800, France; Department of Imaging, Institut Gustave Roussy, Université Paris-Saclay, Villejuif 94800, France
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50
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Garzelli L, Nuzzo A, Hamon A, Ben Abdallah I, Gregory J, Raynaud L, Paulatto L, Dioguardi Burgio M, Castier Y, Panis Y, Vilgrain V, Corcos O, Ronot M. Reperfusion injury on computed tomography following endovascular revascularization of acute mesenteric ischemia: prevalence, risk factors, and patient outcome. Insights Imaging 2022; 13:194. [PMID: 36512135 PMCID: PMC9748024 DOI: 10.1186/s13244-022-01339-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Data about reperfusion injury (RI) following acute arterial mesenteric ischemia (AAMI) in humans are scarce. We aimed to assess the prevalence and risk factors of RI following endovascular revascularization of AMI and evaluate its impact on patient outcomes. METHODS Patients with AAMI who underwent endovascular revascularization (2016-2021) were included in this retrospective cohort. CT performed < 7 days after treatment was reviewed to identify features of RI (bowel wall hypoattenuation, mucosal hyperenhancement). Clinical, laboratory, imaging, and treatments were compared between RI and non-RI patients to identify factors associated with RI. Resection rate and survival were also compared. RESULTS Fifty patients (23 men, median 72-yrs [IQR 60-77]) were included, and 22 were diagnosed with RI (44%) after a median 28 h (22-48). Bowel wall hypoattenuation and mucosal hyperenhancement were found in 95% and 91% of patients with post-interventional RI, respectively. Patients with RI had a greater increase of CRP levels after endovascular treatment (p = 0.01). On multivariate analysis, a decreased bowel wall enhancement on baseline CT (HR = 8.2), an embolic cause (HR = 7.4), complete SMA occlusion (HR = 7.0), and higher serum lactate levels (HR = 1.4) were associated with RI. The three-month survival rate was 78%, with no difference between subgroups (p = 0.99). However, the resection rate was higher in patients with RI (32% versus 7%; p = 0.03). CONCLUSION RI is frequent after endovascular revascularization of AAMI, especially in patients who present with decreased bowel wall enhancement on pre-treatment CT, an embolic cause, and a complete occlusion of the SMA. However, its occurrence does not seem to negatively impact short-term survival.
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Affiliation(s)
- Lorenzo Garzelli
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411599.10000 0000 8595 4540Service de Radiologie, Hôpital Beaujon, APHP.Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France
| | - Alexandre Nuzzo
- grid.411599.10000 0000 8595 4540Intestinal Stroke Center, Service de Gastroenterology, MICI Et Insuffisance Intestinale, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Annick Hamon
- grid.411599.10000 0000 8595 4540Intestinal Stroke Center, Service de Gastroenterology, MICI Et Insuffisance Intestinale, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Iannis Ben Abdallah
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411119.d0000 0000 8588 831XService de Chirurgie Vasculaire, Hôpital Bichat, APHP.Nord, Paris, France
| | - Jules Gregory
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411599.10000 0000 8595 4540Service de Radiologie, Hôpital Beaujon, APHP.Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France
| | - Lucas Raynaud
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411599.10000 0000 8595 4540Service de Radiologie, Hôpital Beaujon, APHP.Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France
| | - Luisa Paulatto
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411599.10000 0000 8595 4540Service de Radiologie, Hôpital Beaujon, APHP.Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France
| | - Marco Dioguardi Burgio
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411599.10000 0000 8595 4540Service de Radiologie, Hôpital Beaujon, APHP.Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France
| | - Yves Castier
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411119.d0000 0000 8588 831XService de Chirurgie Vasculaire, Hôpital Bichat, APHP.Nord, Paris, France
| | - Yves Panis
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411119.d0000 0000 8588 831XService de Chirurgie Digestive, Hôpital Bichat, APHP.Nord, Paris, France
| | - Valérie Vilgrain
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411599.10000 0000 8595 4540Service de Radiologie, Hôpital Beaujon, APHP.Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France
| | - Olivier Corcos
- grid.411599.10000 0000 8595 4540Intestinal Stroke Center, Service de Gastroenterology, MICI Et Insuffisance Intestinale, Hôpital Beaujon, APHP.Nord, Clichy, France
| | - Maxime Ronot
- grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France ,grid.411599.10000 0000 8595 4540Service de Radiologie, Hôpital Beaujon, APHP.Nord, 100 Blvd du Général Leclerc, 92118 Clichy, France
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