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Connell E, Gerard É, Oules B, Brunet-Possenti F, Lamoureux A, Bonnefille H, Mary-Prey S, Carrasquilla A, Mouret S, Kramkimel N, Lesage C, Stoebner PE, Bartoli A, Monestier S, Correard F, Gros A, Jeanson A, Ouafik L, Gaudy-Marqueste C, Tomasini P, Charles J, Amini-Adle M, Malissen N. Molecularly matched targeted therapy: a promising approach for refractory metastatic melanoma. Oncologist 2024:oyae085. [PMID: 38761384 DOI: 10.1093/oncolo/oyae085] [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: 09/20/2023] [Accepted: 03/26/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Only a fraction of patients with metastatic melanoma derive durable benefit from approved treatments. The clinical impact of personalized medicine strategies for melanoma, apart from BRAF, NRAS, or CKIT targeting, has rarely been reported. MATERIALS AND METHODS By means of the Group of Cutaneous Oncology of the French Society of Dermatology, we retrospectively included all patients with advanced melanoma aged 18 years and older for whom molecular testing identified one or more actionable molecular alterations and who accordingly received molecularly matched therapy. We excluded patients with only BRAF, NRAS, or CKIT alterations and patients who received molecularly matched therapy for less than 15 days. RESULTS We included 26 patients with a median follow-up of 8 months (1-54), a median age of 63 years (24-89), and a sex ratio of 2.7. These patients had been heavily pretreated, and 64% had elevated LDH levels. The disease control rate was 38%, with 4 cases of partial response (overall response rate: 15%) and 6 of stable disease for at least 6 months. The median duration of treatment was 3.1 months (0.9-13.5). Among patients with disease control, the median duration of control was 6.6 months (2.6-13.5) and 3 cases were ongoing at the end of the study. Patients with controlled disease had GNA11, MAP2K1, FYCO1-RAF1, HRAS, ATM, CCND1, MDM2/CDK4, and CDKN2A/NRAS alterations. CONCLUSIONS High-throughput sequencing followed by matched targeted therapy is a promising approach for patients with advanced melanoma refractory to approved treatments.
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Affiliation(s)
- Emily Connell
- Dermatology and Skin Cancer Department, Aix Marseille University, APHM, CRCM Inserm U1068, CNRS U7258, Marseille, France
- Department of Early Phase Cancer Trial Center (CEPCM) "CLIP2," Aix Marseille University, APHM, Marseille, France
| | - Émilie Gerard
- Dermatology Department, CHU de Bordeaux, Bordeaux, France
| | | | | | - Anouck Lamoureux
- Dermatology Department, Montpellier Cancer Institute, Montpellier, France
| | | | | | | | - Stéphane Mouret
- Dermatology Department, CHU Grenoble Alpes, University Grenoble Alpes, INSERM U 1209, CNRS UMR 5309, Institut for Advanced Biosciences, Grenoble, France
| | | | - Candice Lesage
- Dermatology Department, CHU de Montpellier, Montpellier, France
| | | | - Axel Bartoli
- Radiology Department, Aix Marseille University, APHM, CERIMED, Marseille, France
| | - Sandrine Monestier
- Dermatology and Skin Cancer Department, Aix Marseille University, APHM, CRCM Inserm U1068, CNRS U7258, Marseille, France
- Department of Early Phase Cancer Trial Center (CEPCM) "CLIP2," Aix Marseille University, APHM, Marseille, France
| | - Florian Correard
- Pharmacy Department, Aix Marseille University, APHM, Marseille, France
| | - Audrey Gros
- Tumor Biology and Tumor Bank Department, University Hospital of Bordeaux, Bordeaux, France
| | - Arnaud Jeanson
- Department of Early Phase Cancer Trial Center (CEPCM) "CLIP2," Aix Marseille University, APHM, Marseille, France
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - L'Houcine Ouafik
- Oncobiology Department, Aix Marseille University, APHM, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Caroline Gaudy-Marqueste
- Dermatology and Skin Cancer Department, Aix Marseille University, APHM, CRCM Inserm U1068, CNRS U7258, Marseille, France
- Department of Early Phase Cancer Trial Center (CEPCM) "CLIP2," Aix Marseille University, APHM, Marseille, France
| | - Pascale Tomasini
- Department of Early Phase Cancer Trial Center (CEPCM) "CLIP2," Aix Marseille University, APHM, Marseille, France
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Julie Charles
- Dermatology Department, CHU Grenoble Alpes, University Grenoble Alpes, INSERM U 1209, CNRS UMR 5309, Institut for Advanced Biosciences, Grenoble, France
| | - Mona Amini-Adle
- Dermatology Department, Leon Bérard Cancer Center, Lyon, France
| | - Nausicaa Malissen
- Dermatology and Skin Cancer Department, Aix Marseille University, APHM, CRCM Inserm U1068, CNRS U7258, Marseille, France
- Department of Early Phase Cancer Trial Center (CEPCM) "CLIP2," Aix Marseille University, APHM, Marseille, France
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Aung N, Bartoli A, Rauseo E, Cortaredona S, Sanghvi MM, Fournel J, Ghattas B, Khanji MY, Petersen SE, Jacquier A. Left Ventricular Trabeculations at Cardiac MRI: Reference Ranges and Association with Cardiovascular Risk Factors in UK Biobank. Radiology 2024; 311:e232455. [PMID: 38563665 DOI: 10.1148/radiol.232455] [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: 04/04/2024]
Abstract
Background The extent of left ventricular (LV) trabeculation and its relationship with cardiovascular (CV) risk factors is unclear. Purpose To apply automated segmentation to UK Biobank cardiac MRI scans to (a) assess the association between individual characteristics and CV risk factors and trabeculated LV mass (LVM) and (b) establish normal reference ranges in a selected group of healthy UK Biobank participants. Materials and Methods In this cross-sectional secondary analysis, prospectively collected data from the UK Biobank (2006 to 2010) were retrospectively analyzed. Automated segmentation of trabeculations was performed using a deep learning algorithm. After excluding individuals with known CV diseases, White adults without CV risk factors (reference group) and those with preexisting CV risk factors (hypertension, hyperlipidemia, diabetes mellitus, or smoking) (exposed group) were compared. Multivariable regression models, adjusted for potential confounders (age, sex, and height), were fitted to evaluate the associations between individual characteristics and CV risk factors and trabeculated LVM. Results Of 43 038 participants (mean age, 64 years ± 8 [SD]; 22 360 women), 28 672 individuals (mean age, 66 years ± 7; 14 918 men) were included in the exposed group, and 7384 individuals (mean age, 60 years ± 7; 4729 women) were included in the reference group. Higher body mass index (BMI) (β = 0.66 [95% CI: 0.63, 0.68]; P < .001), hypertension (β = 0.42 [95% CI: 0.36, 0.48]; P < .001), and higher physical activity level (β = 0.15 [95% CI: 0.12, 0.17]; P < .001) were associated with higher trabeculated LVM. In the reference group, the median trabeculated LVM was 6.3 g (IQR, 4.7-8.5 g) for men and 4.6 g (IQR, 3.4-6.0 g) for women. Median trabeculated LVM decreased with age for men from 6.5 g (IQR, 4.8-8.7 g) at age 45-50 years to 5.9 g (IQR, 4.3-7.8 g) at age 71-80 years (P = .03). Conclusion Higher trabeculated LVM was observed with hypertension, higher BMI, and higher physical activity level. Age- and sex-specific reference ranges of trabeculated LVM in a healthy middle-aged White population were established. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Kawel-Boehm in this issue.
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Affiliation(s)
- Nay Aung
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Axel Bartoli
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Elisa Rauseo
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Sebastien Cortaredona
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Mihir M Sanghvi
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Joris Fournel
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Badih Ghattas
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Mohammed Y Khanji
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Steffen E Petersen
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Alexis Jacquier
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
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Massimi L, Cinalli G, Frassanito P, Arcangeli V, Auer C, Baro V, Bartoli A, Bianchi F, Dietvorst S, Di Rocco F, Gallo P, Giordano F, Hinojosa J, Iglesias S, Jecko V, Kahilogullari G, Knerlich-Lukoschus F, Laera R, Locatelli D, Luglietto D, Luzi M, Messing-Jünger M, Mura R, Ragazzi P, Riffaud L, Roth J, Sagarribay A, Pinheiro MS, Spazzapan P, Spennato P, Syrmos N, Talamonti G, Valentini L, Van Veelen ML, Zucchelli M, Tamburrini G. Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era. Childs Nerv Syst 2024; 40:1221-1237. [PMID: 38456922 DOI: 10.1007/s00381-024-06332-9] [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: 09/29/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017-2019), COVID (2020-2021), and post-COVID period (2022-June 2023) looking for possible epidemiological and/or clinical changes. MATERIAL AND METHODS An English language questionnaire was sent to ESPN members about year of the event, patient's age and gender, presence of immune-deficit or other favoring risk factors, COVID infection, signs and symptoms at onset, site of primary infection, type of intracranial complication, identified germ, type and number of surgical operations, type and duration of medical treatment, clinical and radiological outcome, duration of the follow-up. RESULTS Two hundred fifty-four cases were collected by 30 centers coming from 14 different European countries. There was a statistically significant difference between the post-COVID period (129 children, 86 cases/year, 50.7% of the whole series) and the COVID (40 children, 20 cases/year, 15.7%) or the pre-COVID period (85 children, 28.3 cases/year, 33.5%). Other significant differences concerned the presence of predisposing factors/concurrent diseases (higher in the pre-COVID period) and previous COVID infection (higher in the post-COVID period). No relevant differences occurred as far as demographic, microbiological, clinical, radiological, outcome, morbidity, and mortality data were concerned. Paranasal sinuses and middle ear/mastoid were the most involved primary site of infection (71% and 27%, respectively), while extradural or subdural empyema and brain abscess were the most common ICSO (73% and 17%, respectively). Surgery was required in 95% of cases (neurosurgical and ENT procedure in 71% and 62% of cases, respectively) while antibiotics in 99% of cases. After a 12.4-month follow-up, a full clinical and radiological recovery was obtained in 85% and 84% of cases, respectively. The mortality rate was 2.7%. CONCLUSIONS These results suggest that the occurrence of ICSO was significantly increased after the pandemic. Such an increase seems to be related to the indirect effects of the pandemic (e.g., immunity debt) rather than to a direct effect of COVID infection or to seasonal fluctuations. ICSO remain challenging diseases but the pandemic did not affect the management strategies nor their prognosis. The epidemiological change of sinusitis/otitis and ICSO should alert about the appropriate follow-up of children with sinusitis/otitis.
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Affiliation(s)
- L Massimi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
| | - G Cinalli
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - P Frassanito
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - V Arcangeli
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Auer
- Department of Neurosurgery, Johannes Kepler University Linz, Kepler University Hospital GmbH, Linz, Austria
| | - V Baro
- Pediatric and Functional Neurosurgery, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Bartoli
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - F Bianchi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Dietvorst
- University Hospitals Leuven, Leuven, Belgium
| | - F Di Rocco
- Hôpital Femme-Mère-Enfant, Université de Lyon, Lyon, France
| | - P Gallo
- Birmingham Children's Hospital, Birmingham, UK
| | - F Giordano
- University of Florence, Florence, Italy
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - J Hinojosa
- Hospital Sant Joan de Déu, Barcelona, Spain
| | - S Iglesias
- Hospital Regional Universitario de Malaga, Malaga, Spain
| | - V Jecko
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - G Kahilogullari
- Department of Neurosurgery, Ankara University, Ankara, Turkey
| | - F Knerlich-Lukoschus
- Division Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - R Laera
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - D Locatelli
- Neurosurgery Department, Università Dell'Insubria, Ospedale di Circolo e Macchi Foundation, Varese, Italy
| | - D Luglietto
- Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - M Luzi
- Azienda Ospedaliero Universitaria Delle Marche, Ancona, Italy
| | | | - R Mura
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - P Ragazzi
- Department of Pediatric Neurosurgery, Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - L Riffaud
- Rennes University Hospital, Rennes, France
| | - J Roth
- Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - A Sagarribay
- Hospital Dona Estefânia-Centro Hospitalar Universitário, Lisboa, Portugal
- Hospital CUF Descobertas, Lisboa, Portugal
| | - M Santos Pinheiro
- Centro Hospitalar Lisboa Norte-Hospital Santa Maria, Lisboa, Portugal
| | - P Spazzapan
- University Medical Center-Ljubljana, Ljubljana, Slovenia
| | - P Spennato
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - N Syrmos
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - L Valentini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M L Van Veelen
- Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands
| | - M Zucchelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto Scienze Neurologiche Di Bologna, Boulogne, Italy
| | - G Tamburrini
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
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Maurin A, Jacquier A, Bartoli A, Barral PA, Vecchini F, Mancini J, Omnes V, DeMasi M, Piquet P, Gaudry M. STABILISE (Stent-Assisted Balloon-Induced Intimal Disruption and Relamination in Aortic Dissection Repair) Is Associated With Good Anatomical Results on the Distal Thoracoabdominal Aorta at 2 Years. J Endovasc Ther 2024:15266028241232923. [PMID: 38379335 DOI: 10.1177/15266028241232923] [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: 02/22/2024]
Abstract
PURPOSE The aim of this comparative study was to evaluate the increased aortic diameter of the distal aorta after implementing the STABILISE technique in complicated type B aortic dissection (AD). DESIGN This is a comparative monocentric retrospective study. MATERIALS AND METHODS All patients who underwent an STABILISE procedure for complicated AD between 2018 and 2020 were included and compared with a historic cohort treated with thoracic endovascular aortic repair (TEVAR) alone. Aortic diameters were measured at 6 different levels on the thoracic and abdominal aorta. The primary end point was an increased aortic diameter at 1 and 2 years. The exclusion criterion was the absence of a computed tomography (CT) scan at 1 or 2 years. RESULTS A total of 55 patients were included: 24 in the TEVAR group and 31 in the STABILISE group. At the level of the stent graft, there was a decrease in aortic diameters in both groups without significant differences. At the level of the distal aorta, there was an increase in aortic diameters in both groups without significant differences. There were significantly more patients in the TEVAR group with an unfavorable increase in aortic diameter >5 mm of the distal aorta at 2 years than in the STABILISE group: 8 (33%) vs 1 (3%) (p=0.01). For chronic ADs, a significantly greater increase in aortic diameters of the distal aorta was observed in the STABILISE group. CONCLUSIONS The STABILISE technique is technically feasible and potentially leads to decreased longer re-intervention rates; indeed, more patients had an unfavorable increase in aortic diameter in the TEVAR group than in the STABILISE group at 2 years. The high rate of long-term distal aortic aneurysm progression and reintervention after TEVAR alone suggests that this option is not sufficient to definitively treat these complex patients. CLINICAL IMPACT This article reported the results of stent assisted balloon induced intimal disruption and relamination (STABILISE) with a follow-up at 2 years. This is the first comparative study between STABILISE, which has emerged as a new technique inducing aortic remodeling and therefore better long-term outcome, and the standard technique TEVAR alone. STABILISE technique is associated with good results on the distal aorta at 2 years with a rate of patient with unfavorable aortic diameter evolution greater in TEVAR group compared to STABILISE group and could improve the long-term results on the distal aorta by inducing extensive aortic remodeling.
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Affiliation(s)
- Arnaud Maurin
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Alexis Jacquier
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Axel Bartoli
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Pierre-Antoine Barral
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Fabien Vecchini
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Julien Mancini
- Aix-Marseille Univ, APHM, INSERM, IRD Biostatistics Department, SESSTIM, BIOSTIC, Marseille, France
| | - Virgile Omnes
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Mariangela DeMasi
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Philippe Piquet
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
| | - Marine Gaudry
- Department of Radiology, APHM, Timone Hospital, Marseille, France
- Timone Aortic Center, Department of Vascular Surgery, APHM, Timone Hospital, Marseille, France
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Leclercq B, Bertolino J, Rossillon A, Gariboldi V, El Harake S, Silhol F, Bartoli M, Vaisse B, Bartoli A, Sarlon-Bartoli G. Late Post-Dissection Dynamic Intermittent Malperfusion of the Aortic Arch in Association with a Rare Heterogenous LOX Gene Variation. J Clin Med 2024; 13:952. [PMID: 38398265 PMCID: PMC10888595 DOI: 10.3390/jcm13040952] [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: 12/29/2023] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
Late ischaemic consequences of type A aortic dissection are rare. We present a 6-year late complication of type A aortic dissection treated by Bentall surgery in a 41-year-old patient. The patient presented with several episodes of lipothymia associated with hypertensive attacks with anisotension, cervicalgia, hemicranial headache, abdominal pain and lower limb slipping initially on exertion and later at rest. On dynamic examination, we diagnosed an intermittent dynamic occlusion of the aortic arch and rare LOX gene variation, which is considered to be associated with aneurysm or dissection of the ascending aorta in young patients. Surgical treatment by replacement of the ascending aorta and the aortic arch with reimplantation of the brachiocephalic trunk (BcTr) allowed the symptoms to resolve.
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Affiliation(s)
- Barbara Leclercq
- Vascular Medicine and Arterial Hypertension Departement, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (J.B.); (G.S.-B.)
| | - Julien Bertolino
- Vascular Medicine and Arterial Hypertension Departement, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (J.B.); (G.S.-B.)
| | - Alexandre Rossillon
- Vascular Surgery Department, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (A.R.)
| | - Vlad Gariboldi
- Department of Cardiac Surgery, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - Sarah El Harake
- Vascular Medicine and Arterial Hypertension Departement, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (J.B.); (G.S.-B.)
| | - François Silhol
- Vascular Medicine and Arterial Hypertension Departement, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (J.B.); (G.S.-B.)
| | - Michel Bartoli
- Vascular Surgery Department, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (A.R.)
| | - Bernard Vaisse
- Vascular Medicine and Arterial Hypertension Departement, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (J.B.); (G.S.-B.)
| | - Axel Bartoli
- Radiology Department, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - Gabrielle Sarlon-Bartoli
- Vascular Medicine and Arterial Hypertension Departement, La Timone Hospital, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; (J.B.); (G.S.-B.)
- Center for CardioVascular and Nutrition Research (C2VN), Aix Marseille University, 13005 Marseille, France
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Colin J, Rossetti AO, Daniel RT, Bartoli A, Corniola MV, Vulliemoz S, Seeck M. The impact of a history of status epilepticus for epilepsy surgery outcome. Epilepsy Res 2024; 200:107308. [PMID: 38325236 DOI: 10.1016/j.eplepsyres.2024.107308] [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: 03/27/2023] [Revised: 09/17/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Patients with focal drug resistant epilepsy are excellent candidates for epilepsy surgery. Status epilepticus (SE) and seizure clusters (SC), described in a subset of patients, have both been associated with extended epileptogenic cerebral networks within one or both hemispheres. In this retrospective study, we were interested to determine if a history of SE or SC is associated with a worse surgical outcome. METHODS Data of 244 patients operated between 2000 to 2018 were reviewed, with a follow-up of at least 2 years. Patients with a previous history of SE or SC were compared to operated patients without these conditions (control group, CG). RESULTS We identified 27 (11%) and 38 (15.5%) patients with history of SE or SC, respectively. No difference in post-operative outcome was found for SE and SC patients. Compared to the control group, patients with a history of SE were diagnosed and operated significantly at earlier age(p = 0.01), and after a shorter duration of the disease (p = 0.027), but with a similar age of onset. SIGNIFICANCE A history of SE or SC was not associated with a worse post-operative prognosis. Earlier referral of SE patients for surgery suggests a heightened awareness regarding serious complications of recurrent SE by the referring neurologist or neuropediatrician. While the danger of SE is evident, policies to underline the impact for SC or very frequent seizures might be an efficient approach to accelerate patient referral also for this patient group.
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Affiliation(s)
- J Colin
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland.
| | - A O Rossetti
- Neurology Service, Department of Clinical Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - R T Daniel
- Neurosurgery Service, Department of Clinical Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - A Bartoli
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland
| | - M V Corniola
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland
| | - S Vulliemoz
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland
| | - M Seeck
- EEG and Epilepsy Unit and Neurosurgery Clinics, Department of Clinical Neurosciences, University Hospital of Geneva (HUG) and Faculty of Medicine, Geneva, Switzerland.
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Cadour F, Tradi F, Bartoli A, Duffaud F, Gaubert JY. Diffusion weighted imaging changes in extra-abdominal desmoid tumor after cryotherapy. Ann Med 2023; 55:521-525. [PMID: 36724758 PMCID: PMC10132216 DOI: 10.1080/07853890.2023.2174589] [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] [Indexed: 02/03/2023] Open
Abstract
Desmoid tumors (DT) are rare benign tumors with a local invasion potential and recurrence. It is characterized on histology by an abnormal fibroblastic proliferation in a collagenous stroma, in variable proportions leading to heterogeneity of the lesion signal on magnetic resonance imaging (MRI). Current guidelines propose watchful waiting but in case of progression or symptoms, cryotherapy may be a therapeutic option in its extra-abdominal form. Tumor recurrence is mostly detected based on post-contrast magnetic resonance imaging (MRI). Although DWI sequence is the key-sequence for tumor detection in oncologic imaging, there are very few data in literature on diffusion weighted imaging (DWI) in DT generally and even fewer on DT after cryotherapy. DWI changes after cryotherapy may be confusing and suspicious of residual tumor or tumor recurrence when displaying low ADC values; thus knowledge of possible DWI patterns after cryotherapy of DT seem paramount. We found that the early changes of DT after cryotherapy are hyperintensity on DWI sequence with low ADC values (<1.00 × 10-3mm2/s), without corresponding enhancement and a later decrease in signal of the treated lesion on DWI. The freezing-thawing cycles of cryotherapy turn DT into gelatinous necrosis with a slow resorption rate, as reported in the only few studies referring of changes of DWI signals after cryotherapy, which are on renal and prostate models. Hyperintensity on DWI with low ADC values may be seen in early MRI follow-up after cryotherapy of extra-abdominal DT, corresponding with tumor necrosis changes and should not be mistaken with recurrence.KEY MESSAGESMagnetic resonance imaging is the modality of choice for desmoid tumor (DT) follow-up, mainly based on contrast uptake which make data on diffusion weighted imaging (DWI) very rare.Cryotherapy is an accepted therapeutic option for DT that will lead to tumor necrosis.Hyperintensity on DWI with low apparent diffusion coefficient values is a possible expected early pattern on DWI after cryotherapy of DT.
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Affiliation(s)
- Farah Cadour
- Department of Radiology, La Timone Hospital, Marseille, France
| | - Farouk Tradi
- Department of Radiology, La Timone Hospital, Marseille, France
| | - Axel Bartoli
- Department of Radiology, La Timone Hospital, Marseille, France
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Bartoli A, May A, Al-Awadhi A, Schaller K. Probing artificial intelligence in neurosurgical training: ChatGPT takes a neurosurgical residents written exam. Brain Spine 2023; 4:102715. [PMID: 38163001 PMCID: PMC10753430 DOI: 10.1016/j.bas.2023.102715] [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] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/12/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
Introduction Artificial Intelligence tools are being introduced in almost every field of human life, including medical sciences and medical education, among scepticism and enthusiasm. Research question to assess how a generative language tool (Generative Pretrained Transformer 3.5, ChatGPT) performs at both generating questions and answering a neurosurgical residents' written exam. Namely, to assess how ChatGPT generates questions, how it answers human-generated questions, how residents answer AI-generated questions and how AI answers its self-generated question. Materials and methods 50 questions were included in the written exam, 46 questions were generated by humans (senior staff members) and 4 were generated by ChatGPT. 11 participants took the exam (ChatGPT and 10 residents). Questions were both open-ended and multiple-choice.8 questions were not submitted to ChatGPT since they contained images or schematic drawings to interpret. Results formulating requests to ChatGPT required an iterative process to precise both questions and answers. Chat GPT scored among the lowest ranks (9/11) among all the participants). There was no difference in response rate for residents' between human-generated vs AI-generated questions that could have been attributed to less clarity of the question. ChatGPT answered correctly to all its self-generated questions. Discussion and conclusions AI is a promising and powerful tool for medical education and for specific medical purposes, which need to be further determined. To request AI to generate logical and sound questions, that request must be formulated as precise as possible, framing the content, the type of question and its correct answers.
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Affiliation(s)
- A. Bartoli
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
| | - A.T. May
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
| | - A. Al-Awadhi
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
| | - K. Schaller
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Medical Center, Geneva, Switzerland
- Switzerland & Faculty of Medicine, University of Geneva, Switzerland
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Martin J, Depietro R, Bartoli A, Markarian T, De Maria L, Di Bisceglie M, Persico N, Michelet P, Mege D. Acute mesenteric ischemia: which predictive factors of delayed diagnosis at emergency unit? Eur J Trauma Emerg Surg 2023; 49:1999-2008. [PMID: 36129476 DOI: 10.1007/s00068-022-02112-9] [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: 06/27/2022] [Accepted: 09/09/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Acute mesenteric ischemia (AMI) is frequently diagnosed late, leading to a poor prognosis. Our aims were to identify predictive factors of delayed diagnosis and to analyze the outcomes of patients with AMI admitted in emergency units. METHODS All the patients with AMI (2015-2020), in two Emergency units, were retrospectively included. Two groups were defined according to the time of diagnosis between the arrival at emergency unit and the CT scan: ≤ 6 h (early), > 6 h (delayed). RESULTS 119 patients (mean age = 71 ± 7 years) were included. The patients with a delayed diagnosis (n = 33, 28%) were significantly associated with atypical presentation, including lower rates of abdominal pain (73 vs 89%, p = 0.003), abdominal tenderness (33 vs 43%, p = 0.03), and plasma lactate (4 ± 2 vs 6 ± 7 mmol/l, p = 0.03) when compared with early diagnosis. After multivariate analysis, the absence of abdominal pain was the only independent predictive factor of delayed diagnosis (Odd Ratio = 0.17; 95% CI = 0.03-0.88, p = 0.03). Patients with delayed diagnosis tended to be associated to lower rates of revascularization (9 vs 17%, p = 0.4), higher rates of major surgical morbidity (90 vs 57%, p = 0.1), longer length of stay (16 ± 23 vs 13 ± 15 days, p = 0.4) and, at the end of follow-up, higher rate of short small bowel syndrome (18 vs 7%, p = 0.095). CONCLUSION AMI is a challenge for emergency physicians. History of patient, physical exam, biological data are not sufficient to diagnose AMI. New biomarkers, and awareness of emergency physicians should improve and accelerate the diagnosis of AMI.
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Affiliation(s)
- Julie Martin
- Department of Emergency, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Rémi Depietro
- Department of Digestive Surgery, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Axel Bartoli
- Department of Radiology, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Thibaut Markarian
- Department of Emergency, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Lucille De Maria
- Department of Biochemistry, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Mathieu Di Bisceglie
- Department of Medical Imaging, North Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Nicolas Persico
- Department of Emergency, North Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Pierre Michelet
- Department of Emergency, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France
| | - Diane Mege
- Department of Digestive Surgery, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France.
- Department of Digestive and Oncology Surgery, Timone University Hospital, Aix Marseille Univ, APHM, 264 rue Saint-Pierre, 13005, Marseille, France.
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Debbi K, Habert P, Grob A, Loundou A, Siles P, Bartoli A, Jacquier A. Radiomics model to classify mammary masses using breast DCE-MRI compared to the BI-RADS classification performance. Insights Imaging 2023; 14:64. [PMID: 37052738 PMCID: PMC10102264 DOI: 10.1186/s13244-023-01404-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: 10/14/2022] [Accepted: 01/29/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Recent advanced in radiomics analysis could help to identify breast cancer among benign mammary masses. The aim was to create a radiomics signature using breast DCE-MRI extracted features to classify tumors and to compare the performances with the BI-RADS classification. MATERIAL AND METHODS From September 2017 to December 2019 images, exams and records from consecutive patients with mammary masses on breast DCE-MRI and available histology from one center were retrospectively reviewed (79 patients, 97 masses). Exclusion criterion was malignant uncertainty. The tumors were split in a train-set (70%) and a test-set (30%). From 14 kinetics maps, 89 radiomics features were extracted, for a total of 1246 features per tumor. Feature selection was made using Boruta algorithm, to train a random forest algorithm on the train-set. BI-RADS classification was recorded from two radiologists. RESULTS Seventy-seven patients were analyzed with 94 tumors, (71 malignant, 23 benign). Over 1246 features, 17 were selected from eight kinetic maps. On the test-set, the model reaches an AUC = 0.94 95 CI [0.85-1.00] and a specificity of 33% 95 CI [10-70]. There were 43/94 (46%) lesions BI-RADS4 (4a = 12/94 (13%); 4b = 9/94 (10%); and 4c = 22/94 (23%)). The BI-RADS score reached an AUC = 0.84 95 CI [0.73-0.95] and a specificity of 17% 95 CI [3-56]. There was no significant difference between the ROC curves for the model or the BI-RADS score (p = 0.19). CONCLUSION A radiomics signature from features extracted using breast DCE-MRI can reach an AUC of 0.94 on a test-set and could provide as good results as BI-RADS to classify mammary masses.
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Affiliation(s)
- Kawtar Debbi
- Service de Radiologie, La Timone Hôpital, 264 Rue Saint Pierre, 13005, Marseille, France
| | - Paul Habert
- Service de Radiologie, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France.
- LIIE, Aix Marseille Université, Marseille, France.
- CERIMED, Aix Marseille Université, Marseille, France.
| | - Anaïs Grob
- Service de Radiologie, La Timone Hôpital, 264 Rue Saint Pierre, 13005, Marseille, France
| | - Anderson Loundou
- CEReSS UR3279-Health Service Research and Quality of Life Center, Aix-Marseille Université, Marseille, France
- Department of Public Health, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - Pascale Siles
- Service de Radiologie, La Timone Hôpital, 264 Rue Saint Pierre, 13005, Marseille, France
| | - Axel Bartoli
- Service de Radiologie, La Timone Hôpital, 264 Rue Saint Pierre, 13005, Marseille, France
- UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale - Centre d'Exploration Métaboliques par Résonance Magnétique), Assistance Publique - Hôpitaux de Marseille, Aix-Marseille Université, 13385, Marseille, France
| | - Alexis Jacquier
- Service de Radiologie, La Timone Hôpital, 264 Rue Saint Pierre, 13005, Marseille, France
- UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale - Centre d'Exploration Métaboliques par Résonance Magnétique), Assistance Publique - Hôpitaux de Marseille, Aix-Marseille Université, 13385, Marseille, France
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Boyer J, Bartoli A, Deharo P, Vaillier A, Ferrara J, Barral PA, Jaussaud N, Morera P, Porto A, Collart F, Jacquier A, Cuisset T. Feasibility of Non-Invasive Coronary Artery Disease Screening with Coronary CT Angiography before Transcatheter Aortic Valve Implantation. J Clin Med 2023; 12:jcm12062285. [PMID: 36983286 PMCID: PMC10051299 DOI: 10.3390/jcm12062285] [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] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/03/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
Coronary artery disease (CAD) screening is usually performed before transcatheter aortic valve implantation (TAVI) by invasive coronary angiography (ICA). Computed coronary tomography angiography (CCTA) has shown good diagnostic performance for CAD screening in patients with a low probability of CAD and is systematically performed before TAVI. CCTA could be an efficient alternative to ICA for CAD screening before TAVI. We sought to investigate the diagnostic performance of CCTA in a population of unselected patients without known CAD who were candidates for TAVI. All consecutive patients referred to our center for TAVI without known CAD were enrolled. All patients underwent CCTA and ICA, which were considered the gold standard. A statistical analysis of the diagnostic performance per patient and per artery was performed. 307 consecutive patients were enrolled. CCTA was non-analyzable in 25 patients (8.9%). In the per-patient analysis, CCTA had a sensitivity of 89.6%, a specificity of 90.2%, a positive predictive value of 65.15%, and a negative predictive value of 97.7%. Only five patients were classified as false negatives on the CCTA. Despite some limitations of the study, CCTA seems reliable for CAD screening in patients without known CAD who are candidates for TAVI. By using CCTA, ICA could be avoided in patients with a CAD-RADS score ≤ 2, which represents 74.8% of patients.
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Affiliation(s)
- Jérémy Boyer
- Département de Cardiologie, CHU Timone, 13005 Marseille, France
- Correspondence: ; Tel.: +33-4913-85981
| | - Axel Bartoli
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
- CRMBM-UMR CNRS 7339, Aix-Marseille Université, 27, Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
| | - Pierre Deharo
- Département de Cardiologie, CHU Timone, 13005 Marseille, France
- Aix-Marseille Université, Inserm, Inra, C2VN, 13005 Marseille, France
- Faculté de Médecine, Aix-Marseille Université, 13005 Marseille, France
| | | | - Jérôme Ferrara
- Département de Cardiologie, CHU Timone, 13005 Marseille, France
| | - Pierre-Antoine Barral
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
- CRMBM-UMR CNRS 7339, Aix-Marseille Université, 27, Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
| | - Nicolas Jaussaud
- Service de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Pierre Morera
- Service de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Alizée Porto
- Service de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Frédéric Collart
- Faculté de Médecine, Aix-Marseille Université, 13005 Marseille, France
- Service de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Alexis Jacquier
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
- CRMBM-UMR CNRS 7339, Aix-Marseille Université, 27, Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
| | - Thomas Cuisset
- Département de Cardiologie, CHU Timone, 13005 Marseille, France
- Aix-Marseille Université, Inserm, Inra, C2VN, 13005 Marseille, France
- Faculté de Médecine, Aix-Marseille Université, 13005 Marseille, France
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Oliva F, Bartoli A, Garofalo E, Calabrese M, Oliva G, Maffulli N. Influence of Exercise on Musculoskeletal Disorders Associated with Gut Microbiota: A Narrative Review. Muscles Ligaments Tendons J 2023. [DOI: 10.32098/mltj.01.2023.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Cadour F, Quemeneur M, Biere L, Donal E, Bentatou Z, Eicher JC, Roubille F, Lalande A, Giorgi R, Rapacchi S, Cortaredona S, Tradi F, Bartoli A, Willoteaux S, Delahaye F, Biene SM, Mangin L, Ferrier N, Dacher JN, Bauer F, Leurent G, Lentz PA, Kovacsik H, Croisille P, Thuny F, Bernard M, Guye M, Furber A, Habib G, Jacquier A. Prognostic value of cardiovascular magnetic resonance T1 mapping and extracellular volume fraction in nonischemic dilated cardiomyopathy. J Cardiovasc Magn Reson 2023; 25:7. [PMID: 36747201 PMCID: PMC9900939 DOI: 10.1186/s12968-023-00919-y] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 01/12/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Heart failure- (HF) and arrhythmia-related complications are the main causes of morbidity and mortality in patients with nonischemic dilated cardiomyopathy (NIDCM). Cardiovascular magnetic resonance (CMR) imaging is a noninvasive tool for risk stratification based on fibrosis assessment. Diffuse interstitial fibrosis in NIDCM may be a limitation for fibrosis assessment through late gadolinium enhancement (LGE), which might be overcome through quantitative T1 and extracellular volume (ECV) assessment. T1 and ECV prognostic value for arrhythmia-related events remain poorly investigated. We asked whether T1 and ECV have a prognostic value in NIDCM patients. METHODS This prospective multicenter study analyzed 225 patients with NIDCM confirmed by CMR who were followed up for 2 years. CMR evaluation included LGE, native T1 mapping and ECV values. The primary endpoint was the occurrence of a major adverse cardiovascular event (MACE) which was divided in two groups: HF-related events and arrhythmia-related events. Optimal cutoffs for prediction of MACE occurrence were calculated for all CMR quantitative values. RESULTS Fifty-eight patients (26%) developed a MACE during follow-up, 42 patients (19%) with HF-related events and 16 patients (7%) arrhythmia-related events. T1 Z-score (p = 0.008) and global ECV (p = 0.001) were associated with HF-related events occurrence, in addition to left ventricular ejection fraction (p < 0.001). ECV > 32.1% (optimal cutoff) remained the only CMR independent predictor of HF-related events occurrence (HR 2.15 [1.14-4.07], p = 0.018). In the arrhythmia-related events group, patients had increased native T1 Z-score and ECV values, with both T1 Z-score > 4.2 and ECV > 30.5% (optimal cutoffs) being independent predictors of arrhythmia-related events occurrence (respectively, HR 2.86 [1.06-7.68], p = 0.037 and HR 2.72 [1.01-7.36], p = 0.049). CONCLUSIONS ECV was the sole independent predictive factor for both HF- and arrhythmia-related events in NIDCM patients. Native T1 was also an independent predictor in arrhythmia-related events occurrence. The addition of ECV and more importantly native T1 in the decision-making algorithm may improve arrhythmia risk stratification in NIDCM patients. Trial registration NCT02352129. Registered 2nd February 2015-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02352129.
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Affiliation(s)
- Farah Cadour
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
| | - Morgane Quemeneur
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
| | - Loic Biere
- Department of Cardiology, University Hospital of Angers, 49000 Angers, France
- UMR CNRS 6015-INSERMU1083, Institut Mitovasc, University of Angers, 49000 Angers, France
| | - Erwan Donal
- Department of Cardiology, Inserm, LTSI–UMR 1099, CHU Rennes, Univ Rennes, 35000 Rennes, France
| | - Zakarya Bentatou
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
| | | | - François Roubille
- PhyMedExp, INSERM, CNRS, Cardiology Department, INI-CRT, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Alain Lalande
- ImViA Laboratory, University of Burgundy, 7 Bld Jeanne d’arc, 21000 Dijon, France
- Medical Imaging Department, University Hospital of Dijon, 21000 Dijon, France
| | - Roch Giorgi
- APHM, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Hop Timone, BioSTICBiostatistique et Technologies de l’Information et de la Communication, Aix Marseille Univ, Marseille, France
| | - Stanislas Rapacchi
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
| | - Sébastien Cortaredona
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Farouk Tradi
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
| | - Axel Bartoli
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
| | - Serge Willoteaux
- UMR CNRS 6015-INSERMU1083, Institut Mitovasc, University of Angers, 49000 Angers, France
| | - François Delahaye
- Department of Cardiology, Hospices civils de Lyon, 69002 Lyon, France
| | | | - Lionel Mangin
- Department of Cardiology, CH d’Annecy, 74370 Annecy, France
| | - Nadine Ferrier
- Department of Cardiology, CH de Vichy, 03207 Vichy, France
| | - Jean-Nicolas Dacher
- Department of Radiology, UNIROUEN, Inserm U1096, CHU de Rouen, 76000 Rouen, France
| | - Fabrice Bauer
- INSERM U 1096, Cardiovascular Surgery Department, Pulmonary Hypertension and Advanced Heart Failure Clinic, Rouen University Hospital, Rouen, France
| | - Guillaume Leurent
- Department of Cardiology, Inserm, LTSI–UMR 1099, CHU Rennes, Univ Rennes, 35000 Rennes, France
| | - Pierre-Axel Lentz
- Department of Radiology, University Hospital Pontchaillou, Rennes, France
| | - Hélène Kovacsik
- Departement of Cardiovascular Imaging, Chu Montpellier, Montpellier, France
| | - Pierre Croisille
- Department of Radiology, University Hospital Saint-Etienne, Saint-Étienne, France
- CNRS UMR 5520, INSERM U1294, CREATIS, INSA-Lyon, Univ Lyon, UJM-Saint-Etienne, 42023 Saint-Étienne, France
| | - Franck Thuny
- Unit of Heart Failure and Valvular Heart Diseases, Inserm 1263, Inrae 1260, Department of Cardiology, North Hospital, Assistance Publique - Hôpitaux de Marseille, Centre for CardioVascular and Nutrition Research (C2VN), University Mediterranean Center of Cardio-Oncology, Aix-Marseille University, Marseille, France
| | - Monique Bernard
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
- Faculté de Médecine, CNRS, Aix-Marseille Université, 27 Bd Jean Moulin, 13385 Marseille cedex 5, France
| | - Maxime Guye
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
| | - Alain Furber
- Department of Cardiology, University Hospital of Angers, 49000 Angers, France
- UMR CNRS 6015-INSERMU1083, Institut Mitovasc, University of Angers, 49000 Angers, France
| | - Gilbert Habib
- Cardiology Department, IRD, APHM, MEPHI, IHU-Méditerranée Infection, APHM, La Timone Hospital, Aix Marseille Univ, Marseille, France
| | - Alexis Jacquier
- CNRS, CRMBM, Aix-Marseille University, Marseille, France
- CEMEREM, APHM, CHU Timone, Marseille, France
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Bentatou Z, Troalen T, Bernard M, Guye M, Pini L, Bartoli A, Jacquier A, Kober F, Rapacchi S. Simultaneous multi-slice T1 mapping using MOLLI with blipped CAIPIRINHA bSSFP. Magn Reson Imaging 2023; 95:90-102. [PMID: 32304799 DOI: 10.1016/j.mri.2020.03.006] [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: 01/10/2020] [Revised: 03/02/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study evaluates the possibility for replacing conventional 3 slices, 3 breath-holds MOLLI cardiac T1 mapping with single breath-hold 3 simultaneous multi-slice (SMS3) T1 mapping using blipped-CAIPIRINHA SMS-bSSFP MOLLI sequence. As a major drawback, SMS-bSSFP presents unique artefacts arising from side-lobe slice excitations that are explained by imperfect RF modulation rendering and bSSFP low flip angle enhancement. Amplitude-only RF modulation (AM) is proposed to reduce these artefacts in SMS-MOLLI compared to conventional Wong multi-band RF modulation (WM). MATERIALS AND METHODS Phantoms and ten healthy volunteers were imaged at 1.5 T using a modified blipped-CAIPIRINHA SMS-bSSFP MOLLI sequence with 3 simultaneous slices. WM-SMS3 and AM-SMS3 were compared to conventional single-slice (SMS1) MOLLI. First, SNR degradation and T1 accuracy were measured in phantoms. Second, artefacts from side-lobe excitations were evaluated in a phantom designed to reproduce fat presence near the heart. Third, the occurrence of these artefacts was observed in volunteers, and their impact on T1 quantification was compared between WM-SMS3 and AM-SMS3 with conventional MOLLI as a reference. RESULTS In the phantom, larger slice gaps and slice thicknesses yielded higher SNR. There was no significant difference of T1 values between conventional MOLLI and SMS3-MOLLI (both WM and AM). Positive banding artefacts were identified from fat neighbouring the targeted FOV due to side-lobe excitations from WM and the unique bSSFP signal profile. AM RF pulses reduced these artefacts by 38%. In healthy volunteers, AM-SMS3-MOLLI showed similar artefact reduction compared to WM-SMS3-MOLLI (3 ± 2 vs 5 ± 3 corrupted LV segments out of 16). In-vivo native T1 values obtained from conventional MOLLI and AM-SMS3-MOLLI were equivalent in LV myocardium (SMS1-T1 = 935.5 ± 36.1 ms; AM-SMS3-T1 = 933.8 ± 50.2 ms; P = 0.436) and LV blood pool (SMS1-T1 = 1475.4 ± 35.9 ms; AM-SMS3-T1 = 1452.5 ± 70.3 ms; P = 0.515). Identically, no differences were found between SMS1 and SMS3 postcontrast T1 values in the myocardium (SMS1-T1 = 556.0 ± 19.7 ms; SMS3-T1 = 521.3 ± 28.1 ms; P = 0.626) and the blood (SMS1-T1 = 478 ± 65.1 ms; AM-SMS3-T1 = 447.8 ± 81.5; P = 0.085). CONCLUSIONS Compared to WM RF modulation, AM SMS-bSSFP MOLLI was able to reduce side-lobe artefacts considerably, providing promising results to image the three levels of the heart in a single breath hold. However, few artefacts remained even using AM-SMS-bSSFP due to residual RF imperfections. The proposed blipped-CAIPIRINHA MOLLI T1 mapping sequence provides accurate in vivo T1 quantification in line with those obtained with a single slice acquisition.
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Affiliation(s)
- Zakarya Bentatou
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France; Siemens Healthcare SAS, Saint-Denis, France.
| | | | | | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Lauriane Pini
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Axel Bartoli
- APHM, Hôpital Universitaire Timone, Service de Radiologie, Marseille, France.
| | - Alexis Jacquier
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, Service de Radiologie, Marseille, France.
| | - Frank Kober
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.
| | - Stanislas Rapacchi
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
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Khati I, Jacquier A, Cadour F, Bartoli A, Graber M, Hardwigsen J, Tradi F, Barral PA. Endovascular therapies for hepatic artery stenosis post liver transplantation. CVIR Endovasc 2022; 5:63. [PMID: 36478229 PMCID: PMC9729479 DOI: 10.1186/s42155-022-00338-7] [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] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate primary patency at 12 months after endovascular therapies in hepatic artery stenosis. METHODS A retrospective review of all endovascular interventions for hepatic artery stenosis (HAS) after liver transplantation that occurred between June 2013 and November 2020 was performed at a single institution in France. Follow up occurred from 1 month to 4 years (median 15 months). The treatment consisted of dilation with a balloon or stent. We analyzed short-term (technical success and complications) and long-term outcomes (liver function, arterial patency, graft survival at 12 months (GS), and reintervention). We also compared percutaneous balloon angioplasty (PBA) with stent placement. PBA alone was used if < 30% residual stenosis of the hepatic artery was achieved. Stenting was performed if there was greater than 30% residual stenosis and in the case of complications (dissection or rupture). RESULTS A total of 18 stenoses were suspected on the basis of routine surveillance duplex ultrasound imaging (peak systolic velocity > 200 cm/s, systolic accelerating time > 10 ms and resistive index < 0.5), all of which were confirmed by angio CT, but only 17 were confirmed by angiography. Seventeen patients were included (14 males, mean age 57 years; and three females, mean age 58 years). Interventions were performed in 17 cases (95%) with PBA only (5/17), stent only (5/17) or both (4/17). Immediate technical success was 100%. Major complications occurred in 1 of 17 cases (5.8%), consisting of target vessel dissection. The analysis of the three (groups PBA only, stent only or both) showed the same procedural success (100%), GS (100%) and normal liver function after the procedures but different rates of complications (20% vs. 0% vs. 0%), arterial patency at 12 months (60% vs. 80% vs. 85%) (p = 0.4), early stenosis (40% vs. 80% vs. 0%) or late stenosis (60% vs. 20% vs. 100%) and requirement for reintervention (40% vs. 20% vs. 14%) (p = 0.56). CONCLUSION This study suggests that PBA, stent, or both procedures show the same primary patency at 12 months. It is probably not a definitive answer, but these treatments are safe and effective for extending graft survival in the context of graft shortages.
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Affiliation(s)
- I. Khati
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - A. Jacquier
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - F. Cadour
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - A. Bartoli
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - M. Graber
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - J. Hardwigsen
- grid.411266.60000 0001 0404 1115Department of Surgery, CHU Timone 2, Marseille APHM, Marseille, France
| | - F. Tradi
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
| | - P.-A. Barral
- grid.411266.60000 0001 0404 1115Department of Radiology, CHU Timone 2, Marseille APHM, Marseille, France
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Khitri M, Bartoli A, Maalouf G, Deroux A, Salvarani C, Emmi G, Karadag O, Espinosa G, Leclercq M, Simonini G, Vautier M, Cacoub P, Saadoun D. Tocilizumab dans la maladie de Behçet : étude multicentrique sur 30 patients. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Barral PA, De Masi M, Bartoli A, Beunon P, Gallon A, Tradi F, Hak JF, Gaudry M, Jacquier A. Angio Cone-Beam CT (Angio-CBCT) and 3D Road-Mapping for the Detection of Spinal Cord Vascularization in Patients Requiring Treatment for a Thoracic Aortic Lesion: A Feasibility Study. J Pers Med 2022; 12:1890. [PMID: 36422066 PMCID: PMC9692974 DOI: 10.3390/jpm12111890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Spinal cord ischemia is a major complication of treatment for descending thoracic aorta (DTA) disease. Our objectives were (1) to describe the value of angiographic cone-beam CT (angio-CBCT) and 3D road-mapping to visualize the Adamkiewicz artery (AA) and its feeding artery and (2) to evaluate the impact of AA localization on the patient surgical strategy. METHODS Between 2018 and 2020, all patients referred to our institution for a surgical DTA disorder underwent a dedicated AA evaluation by angio-CBCT. If the AA feeding artery was not depicted on angio-CBCT, selective artery catheterization was performed, guided by 3D road-mapping. Intervention modifications, based on AA location and one month of neurologic follow-up after surgery, were recorded. RESULTS Twenty-one patients were enrolled. AA was assessable in 100% of patients and in 15 (71%) with angio-CBCT alone. Among them, 10 patients needed 3D road-mapping-guided DSA angiography to visualize the AA feeding artery. The amount of contrast media, irradiation dose, and intervention length were not significantly different whether the AA was assessable or not by angio-CBCT. AA feeding artery localization led to surgical sketch modification for 11 patients. CONCLUSIONS Angio-CBCT is an efficient method for AA localization in the surgical planning of DTA disorders.
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Affiliation(s)
- Pierre-Antoine Barral
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
| | - Mariangela De Masi
- Department of Vascular Surgery, CHU Timone, 264, Rue Saint-Pierre, AP-HM, 13005 Marseille, France
- Aortic Center, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
| | - Axel Bartoli
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
- CRMBM-UMR CNRS 7339, Aix-Marseille University, 27, Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
| | - Paul Beunon
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
| | - Arnaud Gallon
- Department of Visceral and Vascular Radiology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France Aortic Center, CHU Timone, AP-HM, 264, Rue Saint-Pierre, CEDEX 1, 13005 Marseille, France
| | - Farouk Tradi
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
| | - Jean-François Hak
- Department of Neuroradiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
| | - Marine Gaudry
- Department of Vascular Surgery, CHU Timone, 264, Rue Saint-Pierre, AP-HM, 13005 Marseille, France
- Aortic Center, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
| | - Alexis Jacquier
- Department of Radiology, CHU Timone, AP-HM, 264, Rue Saint-Pierre, 13005 Marseille, France
- CRMBM-UMR CNRS 7339, Aix-Marseille University, 27, Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
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Panneau J, Mege D, Di Bisceglie M, Duclos J, Habert P, Bartoli A, Vidal V, Tradi F. Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques. Radiographics 2022; 42:E226. [DOI: 10.1148/rg.229013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Alqahtani M, Claudinot A, Gaudry M, Bartoli A, Barral PA, Vidal V, Boyer L, Busa T, Cadour F, Jacquier A, De Masi M, Bal L. Endovascular Management of Vascular Complications in Ehlers-Danlos Syndrome Type IV. J Clin Med 2022; 11:6344. [PMID: 36362573 PMCID: PMC9658028 DOI: 10.3390/jcm11216344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2023] Open
Abstract
(1) Background: The vascular type of Ehlers-Danlos syndrome (vEDS) is a rare genetic connective tissue disorder caused by pathogenic variants in the COL3A1 gene that result in arterial and organ fragility and premature death. We present five cases of vEDS that highlight the diagnosis and treatment challenges encountered by clinicians with these patients. (2) Case presentations: we present the cases of five patients with vascular complications of vEDS who were successfully managed using endovascular interventions or hybrid techniques at our institution from 2005 to 2022. (3) Conclusions: These data emphasize that a multidisciplinary approach is needed for vEDS patients and that when endovascular or hybrid treatment is performed in a timely manner by a skilled team of interventional radiologists, good results can be achieved. Our report also demonstrates that the prognosis of vEDS patients has improved over the past 20 years with a new prevention program including celiprolol therapy, physical activity adaptation and limitation, and scheduled monitoring by expert clinicians.
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Affiliation(s)
- Mubarak Alqahtani
- Department of Radiology, Hôpital de la Timone, AP-HM, 13005 Marseille, France
| | | | - Marine Gaudry
- Aortic Center, Hopital de la Timone, AP-HM, 13005 Marseille, France
- Department of Vascular Surgery, Hopital de la Timone, AP-HM, 13005 Marseille, France
| | - Axel Bartoli
- Department of Radiology, Hôpital de la Timone, AP-HM, 13005 Marseille, France
- CRMBM-UMR CNRS 7339, Aix-Marseille University, 13007 Marseille, France
| | | | - Vincent Vidal
- Department of Radiology, Hôpital de la Timone, AP-HM, 13005 Marseille, France
| | - Louis Boyer
- Department of Radiology, University Hospital, 63100 Clermont-Ferrand, France
| | - Tiffany Busa
- Department of Medical Genetics, Hopital Enfants de la Timone, AP-HM, 13005 Marseille, France
- Regional Reference Department for Marfan and Related Diseases, AP-HM, 13005 Marseille, France
| | - Farah Cadour
- Department of Radiology, Hôpital de la Timone, AP-HM, 13005 Marseille, France
| | - Alexis Jacquier
- Department of Radiology, Hôpital de la Timone, AP-HM, 13005 Marseille, France
- CRMBM-UMR CNRS 7339, Aix-Marseille University, 13007 Marseille, France
| | - Mariangela De Masi
- Aortic Center, Hopital de la Timone, AP-HM, 13005 Marseille, France
- Department of Vascular Surgery, Hopital de la Timone, AP-HM, 13005 Marseille, France
| | - Laurence Bal
- Aortic Center, Hopital de la Timone, AP-HM, 13005 Marseille, France
- Department of Vascular Surgery, Hopital de la Timone, AP-HM, 13005 Marseille, France
- Regional Reference Department for Marfan and Related Diseases, AP-HM, 13005 Marseille, France
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Panneau J, Mege D, Di Biseglie M, Duclos J, Habert P, Bartoli A, Vidal V, Tradi F. Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques. Radiographics 2022; 42:1829-1844. [DOI: 10.1148/rg.220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Boussuges A, Habert P, Chaumet G, Rouibah R, Delorme L, Menard A, Million M, Bartoli A, Guedj E, Gouitaa M, Zieleskiewicz L, Finance J, Coiffard B, Delliaux S, Brégeon F. Diaphragm dysfunction after severe COVID-19: An ultrasound study. Front Med (Lausanne) 2022; 9:949281. [PMID: 36091672 PMCID: PMC9448976 DOI: 10.3389/fmed.2022.949281] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSARS-CoV-2 infection can impair diaphragm function at the acute phase but the frequency of diaphragm dysfunction after recovery from COVID-19 remains unknown.Materials and methodsThis study was carried out on patients reporting persistent respiratory symptoms 3–4 months after severe COVID-19 pneumonia. The included patients were selected from a medical consultation designed to screen for recovery after acute infection. Respiratory function was assessed by a pulmonary function test, and diaphragm function was studied by ultrasonography.ResultsIn total, 132 patients (85M, 47W) were recruited from the medical consultation. During the acute phase of the infection, the severity of the clinical status led to ICU admission for 58 patients (44%). Diaphragm dysfunction (DD) was detected by ultrasonography in 13 patients, two of whom suffered from hemidiaphragm paralysis. Patients with DD had more frequently muscle pain complaints and had a higher frequency of prior cardiothoracic or upper abdominal surgery than patients with normal diaphragm function. Pulmonary function testing revealed a significant decrease in lung volumes and DLCO and the dyspnea scores (mMRC and Borg10 scores) were significantly increased in patients with DD. Improvement in respiratory function was recorded in seven out of nine patients assessed 6 months after the first ultrasound examination.ConclusionAssessment of diaphragm function by ultrasonography after severe COVID-19 pneumonia revealed signs of dysfunction in 10% of our population. In some cases, ultrasound examination probably discovered an un-recognized pre-existing DD. COVID-19 nonetheless contributed to impairment of diaphragm function. Prolonged respiratory physiotherapy led to improvement in respiratory function in most patients.Clinical trial registration[www.cnil.fr], identifier [#PADS20-207].
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Affiliation(s)
- Alain Boussuges
- Faculté de Médecine, Center for Cardiovascular and Nutrition Research, C2VN, INSERM 1263, INRAE 1260, Aix-Marseille University, Marseille, France
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
- *Correspondence: Alain Boussuges, ,
| | - Paul Habert
- Département d’Imagerie, Hôpital Nord, APHM, LIIE, Aix-Marseille University, Marseille, France
| | | | - Rawah Rouibah
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
| | - Lea Delorme
- IRD, IHU-Méditerranée Infection, Marseille, France
| | - Amelie Menard
- Unité Post COVID, Service de Médecine Interne, Hôpital Nord, APHM, Marseille, France
| | - Matthieu Million
- Microbes Evolution Phylogeny and Infections (MEPHI), IHU-Méditerranée Infection, APHM, Aix-Marseille University, Marseille, France
| | - Axel Bartoli
- Département de Radiologie, CNRS, CRMBM, Hôpital Timone, APHM, Aix-Marseille University, Marseille, France
| | - Eric Guedj
- Department of Nuclear Medicine, CNRS, Centrale Marseille, Institut Fresnel, Hôpital Timone, CERIMED, APHM, Aix-Marseille University, Marseille, France
| | - Marion Gouitaa
- Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, APHM, Marseille, France
| | - Laurent Zieleskiewicz
- Faculté de Médecine, Center for Cardiovascular and Nutrition Research, C2VN, INSERM 1263, INRAE 1260, Aix-Marseille University, Marseille, France
- Service d’Anesthésie et Réanimation, Hôpital Nord, Marseille, France
| | - Julie Finance
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
| | - Benjamin Coiffard
- Département des Maladies Respiratoire et Transplantation Pulmonaire, Hôpital Nord, APHM, Aix-Marseille University, Marseille, France
| | - Stephane Delliaux
- Faculté de Médecine, Center for Cardiovascular and Nutrition Research, C2VN, INSERM 1263, INRAE 1260, Aix-Marseille University, Marseille, France
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
| | - Fabienne Brégeon
- Explorations Fonctionnelles Respiratoires, Hôpital Nord, APHM, Marseille, France
- Microbes Evolution Phylogeny and Infections (MEPHI), IHU-Méditerranée Infection, APHM, Aix-Marseille University, Marseille, France
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Bartoli A, Fournel J, Ait-Yahia L, Cadour F, Tradi F, Ghattas B, Cortaredona S, Million M, Lasbleiz A, Dutour A, Gaborit B, Jacquier A. Automatic Deep-Learning Segmentation of Epicardial Adipose Tissue from Low-Dose Chest CT and Prognosis Impact on COVID-19. Cells 2022; 11:cells11061034. [PMID: 35326485 PMCID: PMC8947414 DOI: 10.3390/cells11061034] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To develop a deep-learning (DL) pipeline that allowed an automated segmentation of epicardial adipose tissue (EAT) from low-dose computed tomography (LDCT) and investigate the link between EAT and COVID-19 clinical outcomes. Methods: This monocentric retrospective study included 353 patients: 95 for training, 20 for testing, and 238 for prognosis evaluation. EAT segmentation was obtained after thresholding on a manually segmented pericardial volume. The model was evaluated with Dice coefficient (DSC), inter-and intraobserver reproducibility, and clinical measures. Uni-and multi-variate analyzes were conducted to assess the prognosis value of the EAT volume, EAT extent, and lung lesion extent on clinical outcomes, including hospitalization, oxygen therapy, intensive care unit admission and death. Results: The mean DSC for EAT volumes was 0.85 ± 0.05. For EAT volume, the mean absolute error was 11.7 ± 8.1 cm3 with a non-significant bias of −4.0 ± 13.9 cm3 and a correlation of 0.963 with the manual measures (p < 0.01). The multivariate model providing the higher AUC to predict adverse outcome include both EAT extent and lung lesion extent (AUC = 0.805). Conclusions: A DL algorithm was developed and evaluated to obtain reproducible and precise EAT segmentation on LDCT. EAT extent in association with lung lesion extent was associated with adverse clinical outcomes with an AUC = 0.805.
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Affiliation(s)
- Axel Bartoli
- Department of Radiology, Hôpital de la TIMONE, AP-HM, 13005 Marseille, France; (L.A.-Y.); (F.C.); (F.T.); (A.J.)
- CRMBM—UMR CNRS 7339, Aix-Marseille University, 27, Boulevard Jean Moulin, 13005 Marseille, France;
- Correspondence: ; Tel.: +33-6-64-53-16-82
| | - Joris Fournel
- CRMBM—UMR CNRS 7339, Aix-Marseille University, 27, Boulevard Jean Moulin, 13005 Marseille, France;
| | - Léa Ait-Yahia
- Department of Radiology, Hôpital de la TIMONE, AP-HM, 13005 Marseille, France; (L.A.-Y.); (F.C.); (F.T.); (A.J.)
| | - Farah Cadour
- Department of Radiology, Hôpital de la TIMONE, AP-HM, 13005 Marseille, France; (L.A.-Y.); (F.C.); (F.T.); (A.J.)
- CRMBM—UMR CNRS 7339, Aix-Marseille University, 27, Boulevard Jean Moulin, 13005 Marseille, France;
| | - Farouk Tradi
- Department of Radiology, Hôpital de la TIMONE, AP-HM, 13005 Marseille, France; (L.A.-Y.); (F.C.); (F.T.); (A.J.)
| | - Badih Ghattas
- I2M—UMR CNRS 7373, Luminy Faculty of Sciences, Aix-Marseille University, 163 Avenue de Luminy, Case 901, 13009 Marseille, France;
| | - Sébastien Cortaredona
- IHU Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (S.C.); (M.M.)
- VITROME, SSA, IRD, Aix-Marseille University, 13005 Marseille, France
| | - Matthieu Million
- IHU Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France; (S.C.); (M.M.)
- MEPHI, IRD, AP-HM, Aix Marseille University, 13005 Marseille, France
| | - Adèle Lasbleiz
- C2VN, INRAE, INSERM, Aix Marseille University, 27, Boulevard Jean Moulin, 13005 Marseille, France; (A.L.); (A.D.); (B.G.)
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, AP-HM, 13915 Marseille, France
| | - Anne Dutour
- C2VN, INRAE, INSERM, Aix Marseille University, 27, Boulevard Jean Moulin, 13005 Marseille, France; (A.L.); (A.D.); (B.G.)
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, AP-HM, 13915 Marseille, France
| | - Bénédicte Gaborit
- C2VN, INRAE, INSERM, Aix Marseille University, 27, Boulevard Jean Moulin, 13005 Marseille, France; (A.L.); (A.D.); (B.G.)
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, AP-HM, 13915 Marseille, France
| | - Alexis Jacquier
- Department of Radiology, Hôpital de la TIMONE, AP-HM, 13005 Marseille, France; (L.A.-Y.); (F.C.); (F.T.); (A.J.)
- CRMBM—UMR CNRS 7339, Aix-Marseille University, 27, Boulevard Jean Moulin, 13005 Marseille, France;
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23
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Bartoli A, Fournel J, Maurin A, Marchi B, Habert P, Castelli M, Gaubert JY, Cortaredona S, Lagier JC, Million M, Raoult D, Ghattas B, Jacquier A. Value and prognostic impact of a deep learning segmentation model of COVID-19 lung lesions on low-dose chest CT. Res Diagn Interv Imaging 2022; 1:100003. [PMID: 37520010 PMCID: PMC8939894 DOI: 10.1016/j.redii.2022.100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 12/23/2022]
Abstract
Objectives 1) To develop a deep learning (DL) pipeline allowing quantification of COVID-19 pulmonary lesions on low-dose computed tomography (LDCT). 2) To assess the prognostic value of DL-driven lesion quantification. Methods This monocentric retrospective study included training and test datasets taken from 144 and 30 patients, respectively. The reference was the manual segmentation of 3 labels: normal lung, ground-glass opacity(GGO) and consolidation(Cons). Model performance was evaluated with technical metrics, disease volume and extent. Intra- and interobserver agreement were recorded. The prognostic value of DL-driven disease extent was assessed in 1621 distinct patients using C-statistics. The end point was a combined outcome defined as death, hospitalization>10 days, intensive care unit hospitalization or oxygen therapy. Results The Dice coefficients for lesion (GGO+Cons) segmentations were 0.75±0.08, exceeding the values for human interobserver (0.70±0.08; 0.70±0.10) and intraobserver measures (0.72±0.09). DL-driven lesion quantification had a stronger correlation with the reference than inter- or intraobserver measures. After stepwise selection and adjustment for clinical characteristics, quantification significantly increased the prognostic accuracy of the model (0.82 vs. 0.90; p<0.0001). Conclusions A DL-driven model can provide reproducible and accurate segmentation of COVID-19 lesions on LDCT. Automatic lesion quantification has independent prognostic value for the identification of high-risk patients.
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Key Words
- ACE, angiotensin-converting enzyme
- Artificial intelligence
- BMI, body mass index
- CNN, convolutional neural network
- COVID-19
- COVID-19, coronavirus disease 2019
- CT-SS, chest tomography severity score
- Cons, consolidation
- DL, deep learning
- DSC, Dice similarity coefficient
- Deep learning
- Diagnostic imaging
- GGO, ground-glass opacity
- ICU, intensive care unit
- LDCT, low-dose computed tomography
- MAE, mean absolute error
- MVSF, mean volume similarity fraction
- Multidetector computed tomography
- ROC, receiver operating characteristic
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Affiliation(s)
- Axel Bartoli
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
- CRMBM - UMR CNRS 7339, Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Joris Fournel
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
- CRMBM - UMR CNRS 7339, Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Arnaud Maurin
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
| | - Baptiste Marchi
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
| | - Paul Habert
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
- LIEE, Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
- CERIMED, Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Maxime Castelli
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
| | - Jean-Yves Gaubert
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
- LIEE, Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
- CERIMED, Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Sebastien Cortaredona
- Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
- IRD, VITROME, Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
| | - Jean-Christophe Lagier
- Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
- IRD, MEPHI, Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
| | - Matthieu Million
- Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
- IRD, MEPHI, Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
| | - Didier Raoult
- Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
- IRD, MEPHI, Institut Hospitalo-Universitaire Méditerannée Infection, 19-21 boulevard Jean Moulin, 13005, Marseille, France
| | - Badih Ghattas
- I2M - UMR CNRS 7373, Aix-Marseille University. CNRS, Centrale Marseille, 13453 Marseille, France
| | - Alexis Jacquier
- Department of Radiology, Hôpital de la Timone Adultes, AP-HM. 264, rue Saint-Pierre, 13385 Marseille Cedex 05, France
- CRMBM - UMR CNRS 7339, Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
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Pirocca U, Hadouiri N, Bartoli A, Morcet-Delattre T, Pontana F, Cochet H, Tacher V, Cadour F, Mandry D, Jacquier A. How attractive is cardiac imaging to French radiology residents? Diagn Interv Imaging 2022; 103:185-188. [PMID: 34998710 DOI: 10.1016/j.diii.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/21/2021] [Accepted: 12/27/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Ugo Pirocca
- Department of Radiology, Centre Hospitalier Universitaire de Besançon, 25030 Besançon, France
| | - Nawale Hadouiri
- Department of Physical Medicine and Rehabilitation, Center Hospitalier Universitaire de Dijon, 21000 Dijon, France; InterSyndicale Nationale des Internes, 75005 Paris, France.
| | - Axel Bartoli
- Department of Interventional Radiology, AP-HM, Hôpital La Timone, 13005 Marseille, France
| | | | - François Pontana
- Department of Cardiovascular Radiology, Institut Pasteur de Lille, CHU de Lille, Université de Lille, U1011 - EGID, INSERM, 59000 Lille, France
| | - Hubert Cochet
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
| | - Vania Tacher
- Unité Inserm U955, Équipe 18, Université Paris Est, 94010 Créteil, France; Department of Radiology, Hôpital Henri-Mondor, AP-HP, 94010 Créteil, France
| | - Farah Cadour
- Department of Interventional Radiology, AP-HM, Hôpital La Timone, 13005 Marseille, France
| | - Damien Mandry
- Department of Radiology, CHRU-Nancy, Université de Lorraine, 54035 Nancy, France
| | - Alexis Jacquier
- Department of Interventional Radiology, AP-HM, Hôpital La Timone, 13005 Marseille, France
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25
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Rabbani N, Calvet L, Espinel Y, Le Roy B, Ribeiro M, Buc E, Bartoli A. A methodology and clinical dataset with ground-truth to evaluate registration accuracy quantitatively in computer-assisted Laparoscopic Liver Resection. Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization 2021. [DOI: 10.1080/21681163.2021.1997642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N. Rabbani
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - L. Calvet
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
- IRIT, University of Toulouse
| | - Y. Espinel
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - B. Le Roy
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Saint-Etienne, France
| | - M. Ribeiro
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - E. Buc
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - A. Bartoli
- EnCoV, Institut Pascal, Clermont-Ferrand, France
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26
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Fournel J, Bartoli A, Bendahan D, Guye M, Bernard M, Rauseo E, Khanji MY, Petersen SE, Jacquier A, Ghattas B. Medical image segmentation automatic quality control: A multi-dimensional approach. Med Image Anal 2021; 74:102213. [PMID: 34455223 DOI: 10.1016/j.media.2021.102213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/15/2020] [Revised: 07/09/2021] [Accepted: 08/10/2021] [Indexed: 01/03/2023]
Abstract
In clinical applications, using erroneous segmentations of medical images can have dramatic consequences. Current approaches dedicated to medical image segmentation automatic quality control do not predict segmentation quality at slice-level (2D), resulting in sub-optimal evaluations. Our 2D-based deep learning method simultaneously performs quality control at 2D-level and 3D-level for cardiovascular MR image segmentations. We compared it with 3D approaches by training both on 36,540 (2D) / 3842 (3D) samples to predict Dice Similarity Coefficients (DSC) for 4 different structures from the left ventricle, i.e., trabeculations (LVT), myocardium (LVM), papillary muscles (LVPM) and blood (LVC). The 2D-based method outperformed the 3D method. At the 2D-level, the mean absolute errors (MAEs) of the DSC predictions for 3823 samples, were 0.02, 0.02, 0.05 and 0.02 for LVM, LVC, LVT and LVPM, respectively. At the 3D-level, for 402 samples, the corresponding MAEs were 0.02, 0.01, 0.02 and 0.04. The method was validated in a clinical practice evaluation against semi-qualitative scores provided by expert cardiologists for 1016 subjects of the UK BioBank. Finally, we provided evidence that a multi-level QC could be used to enhance clinical measurements derived from image segmentations.
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Affiliation(s)
- Joris Fournel
- C.N.R.S., C.R.M.B.M., Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France; Aix Marseille Univ, CNRS, I2M, Marseille, France.
| | - Axel Bartoli
- Department of Radiology, Hôpital de la Timone Adultes, A.P.H.M. 264, rue Saint-Pierre 13385 Marseille Cedex 05, France
| | - David Bendahan
- C.N.R.S., C.R.M.B.M., Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Maxime Guye
- C.N.R.S., C.R.M.B.M., Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Monique Bernard
- C.N.R.S., C.R.M.B.M., Medical Faculty, Aix-Marseille University, 27, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Elisa Rauseo
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London, EC1M 6BQ, UK; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, EC1A 7BE, London, UK
| | - Mohammed Y Khanji
- Department of Cardiology, Newham University Hospital, Barts Health NHS Trust, Glen Road, London E13 8SL, UK; William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London, EC1M 6BQ, UK; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, EC1A 7BE, London, UK
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London, EC1M 6BQ, UK; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, EC1A 7BE, London, UK; Health Data Research UK, London, UK; Alan Turing Institute, London, UK
| | - Alexis Jacquier
- Department of Radiology, Hôpital de la Timone Adultes, A.P.H.M. 264, rue Saint-Pierre 13385 Marseille Cedex 05, France
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27
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Lasbleiz A, Gaborit B, Soghomonian A, Bartoli A, Ancel P, Jacquier A, Dutour A. COVID-19 and Obesity: Role of Ectopic Visceral and Epicardial Adipose Tissues in Myocardial Injury. Front Endocrinol (Lausanne) 2021; 12:726967. [PMID: 34484128 PMCID: PMC8415546 DOI: 10.3389/fendo.2021.726967] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
In March 2020, the WHO declared coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a global pandemic. Obesity was soon identified as a risk factor for poor prognosis, with an increased risk of intensive care admissions and mechanical ventilation, but also of adverse cardiovascular events. Obesity is associated with adipose tissue, chronic low-grade inflammation, and immune dysregulation with hypertrophy and hyperplasia of adipocytes and overexpression of pro-inflammatory cytokines. However, to implement appropriate therapeutic strategies, exact mechanisms must be clarified. The role of white visceral adipose tissue, increased in individuals with obesity, seems important, as a viral reservoir for SARS-CoV-2 via angiotensin-converting enzyme 2 (ACE2) receptors. After infection of host cells, the activation of pro-inflammatory cytokines creates a setting conducive to the "cytokine storm" and macrophage activation syndrome associated with progression to acute respiratory distress syndrome. In obesity, systemic viral spread, entry, and prolonged viral shedding in already inflamed adipose tissue may spur immune responses and subsequent amplification of a cytokine cascade, causing worse outcomes. More precisely, visceral adipose tissue, more than subcutaneous fat, could predict intensive care admission; and lower density of epicardial adipose tissue (EAT) could be associated with worse outcome. EAT, an ectopic adipose tissue that surrounds the myocardium, could fuel COVID-19-induced cardiac injury and myocarditis, and extensive pneumopathy, by strong expression of inflammatory mediators that could diffuse paracrinally through the vascular wall. The purpose of this review is to ascertain what mechanisms may be involved in unfavorable prognosis among COVID-19 patients with obesity, especially cardiovascular events, emphasizing the harmful role of excess ectopic adipose tissue, particularly EAT.
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Affiliation(s)
- Adèle Lasbleiz
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - Bénédicte Gaborit
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - Astrid Soghomonian
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
| | - Axel Bartoli
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Medical Imaging, Hôpital Universitaire Timone APHM, Marseille, France
| | - Patricia Ancel
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - Alexis Jacquier
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Medical Imaging, Hôpital Universitaire Timone APHM, Marseille, France
| | - Anne Dutour
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Marseille, France
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
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Habert P, Di Bisceglie M, Hak JF, Brige P, Chopinet S, Mancini J, Bartoli A, Vidal V, Roux C, Tselikas L, De Baere T, Gaubert JY. Percutaneous lung and liver CT-guided ablation on swine model using microwave ablation to determine ablation size for clinical practice. Int J Hyperthermia 2021; 38:1140-1148. [PMID: 34353206 DOI: 10.1080/02656736.2021.1961883] [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: 10/20/2022] Open
Abstract
PURPOSE Microwave ablation (MWA) provides an effective treatment of lung and liver tumors but suffers from a lack of reproducibility of ablation size among currently available technologies. In-vitro evaluations are far removed from clinical practices because of uninfused tissue. This study is in-vivo preclinical testing of a new MWA system on swine lungs and liver. MATERIALS AND METHODS All ablations were performed under CT guidance and multiple algorithms were tested with a power of 50, 75, and 100 W for durations of 3, 5, 8, 10, and 15 min. A 3 D-evaluation of the ablation zone was carried out using enhanced-CT. The sphericity index, coefficients of variation, and energy efficiency (which corresponds to the volume yield according to the power supplied) were calculated. RESULTS Fifty liver and 48 lung ablations were performed in 17 swine. The sphericity index varies from 0.50 to 0.80 for liver ablations and from 0.40 to 0.69 for lung ablations. The coefficient of variation was below 15% for 4/5 and 4/8 protocols for lung and liver ablations, respectively. The energy efficiency seems to decrease with the duration of the ablation from 0.60 × 10-3 cm3/J (75 W, 3 min) to 0.26 × 10-3 cm3/J (100 W, 15 min) in the liver and from 0.57 × 10-3 cm3/J (50 W, 10 min) to 0.42 × 10-3 cm3/J (100 W, 12 min) in the lungs. CONCLUSION A shorter treatment time provides the best energy efficiency, and the best reproducibility is obtained for a 10 min treatment duration. The system tested provides an interesting reproducibility in both lung and liver measurements. Our results may help interventional radiologists in the optimal selection of treatment parameters.
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Affiliation(s)
- Paul Habert
- Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Mathieu Di Bisceglie
- Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Jean-François Hak
- Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Pauline Brige
- Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Sophie Chopinet
- Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France.,Department of Visceral Surgery, Assistance Publique Hopitaux de Marseille, Marseille, France
| | - Julien Mancini
- Biostatistics Department, BIOSTIC, Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, Hop Timone, Marseille, France
| | - Axel Bartoli
- Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, Marseille, France
| | - Vincent Vidal
- Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Charles Roux
- Departement d'Anesthesie, Chirurgie et Interventionel, Gustave Roussy, Paris, France.,Université Paris-Saclay, Paris, France
| | - Lambros Tselikas
- Departement d'Anesthesie, Chirurgie et Interventionel, Gustave Roussy, Paris, France.,Université Paris-Saclay, Paris, France
| | - Thierry De Baere
- Departement d'Anesthesie, Chirurgie et Interventionel, Gustave Roussy, Paris, France.,Université Paris-Saclay, Paris, France
| | - Jean-Yves Gaubert
- Department of Interventional Imaging, Assistance Publique Hopitaux de Marseille, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
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Habert P, Di Bisceglie M, Bartoli A, Jacquier A, Brige P, Vidal V, Hak JF, Tradi F, Gaubert JY. Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT. Int J Hyperthermia 2021; 38:786-794. [PMID: 34032532 DOI: 10.1080/02656736.2021.1928773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for pulmonary tumors. Patterns on chest computed tomography (CT) after RFA are classified into five types; however, the follow-up has not been fully described. The objectives of this study were to describe (1) the CT pattern 3 years after RFA and (2) its evolution over 7 years. MATERIALS AND METHODS Lesions treated with RFA between 2009 and 2017 and with ≥3 years of follow-up CT data were included. Lesions with local recurrences were excluded from the study. The morphology of the ablation zone was classified as nodular, fibrotic, atelectatic, cavitary, and disappeared. Other initial anatomical parameters were recorded. Kruskal-Wallis or Chi-square tests were used to compare the groups. RESULTS One hundred lung RFA scars were included, and a retrospective longitudinal study was performed. Three years after RFA, nodular, fibrotic, atelectatic, and cavitary scars, and disappearance were observed in 49%, 36%, 5%, 3%, and 6% of the scars, respectively. Evolution over 7 years showed that the fibrosis, atelectasis, and disappearance remained stable over time, whereas 28% of nodular scars evolved into fibrotic scars. Additionally, 45% of cavitary scars evolved into nodular scars. Pleural contact was associated with disappearance, and the use of a 20-mm needle was associated with atelectasis. CONCLUSION Follow-up after RFA showed that fibrosis, disappearance, and atelectasis remained stable over time. Nodular scars could evolve into fibrotic scars, and cavitary scars could evolve into nodular scars.
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Affiliation(s)
- Paul Habert
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Mathieu Di Bisceglie
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Axel Bartoli
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,Centre d'exploration métabolique par résonnance magnétique CEMEREM, Aix-Marseille Université, Marseille, France
| | - Alexis Jacquier
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,Centre d'exploration métabolique par résonnance magnétique CEMEREM, Aix-Marseille Université, Marseille, France
| | - Pauline Brige
- LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Vincent Vidal
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Jean-François Hak
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Farouk Tradi
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
| | - Jean-Yves Gaubert
- Department of Medical Imaging, La Timone Hôpital, Marseille, France.,LIIE, Aix Marseille University, Marseille, France.,CERIMED, Aix Marseille University, Marseille, France
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Bartoli A, Fournel J, Bentatou Z, Habib G, Lalande A, Bernard M, Boussel L, Pontana F, Dacher JN, Ghattas B, Jacquier A. Deep Learning-based Automated Segmentation of Left Ventricular Trabeculations and Myocardium on Cardiac MR Images: A Feasibility Study. Radiol Artif Intell 2021; 3:e200021. [PMID: 33937851 DOI: 10.1148/ryai.2020200021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 08/16/2020] [Accepted: 09/16/2020] [Indexed: 01/25/2023]
Abstract
Purpose To develop and evaluate a complete deep learning pipeline that allows fully automated end-diastolic left ventricle (LV) cardiac MRI segmentation, including trabeculations and automatic quality control of the predicted segmentation. Materials and Methods This multicenter retrospective study includes training, validation, and testing datasets of 272, 27, and 150 cardiac MR images, respectively, collected between 2012 and 2018. The reference standard was the manual segmentation of four LV anatomic structures performed on end-diastolic short-axis cine cardiac MRI: LV trabeculations, LV myocardium, LV papillary muscles, and the LV blood cavity. The automatic pipeline was composed of five steps with a DenseNet architecture. Intraobserver agreement, interobserver agreement, and interaction time were recorded. The analysis includes the correlation between the manual and automated segmentation, a reproducibility comparison, and Bland-Altman plots. Results The automated method achieved mean Dice coefficients of 0.96 ± 0.01 (standard deviation) for LV blood cavity, 0.89 ± 0.03 for LV myocardium, and 0.62 ± 0.08 for LV trabeculation (mean absolute error, 3.63 g ± 3.4). Automatic quantification of LV end-diastolic volume, LV myocardium mass, LV trabeculation, and trabeculation mass-to-total myocardial mass (TMM) ratio showed a significant correlation with the manual measures (r = 0.99, 0.99, 0.90, and 0.83, respectively; all P < .01). On a subset of 48 patients, the mean Dice value for LV trabeculation was 0.63 ± 0.10 or higher compared with the human interobserver (0.44 ± 0.09; P < .01) and intraobserver measures (0.58 ± 0.09; P < .01). Automatic quantification of the trabeculation mass-to-TMM ratio had a higher correlation (0.92) compared with the intra- and interobserver measures (0.74 and 0.39, respectively; both P < .01). Conclusion Automated deep learning framework can achieve reproducible and quality-controlled segmentation of cardiac trabeculations, outperforming inter- and intraobserver analyses.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Axel Bartoli
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Joris Fournel
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Zakarya Bentatou
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Gilbert Habib
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Alain Lalande
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Monique Bernard
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Loïc Boussel
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - François Pontana
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Jean-Nicolas Dacher
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Badih Ghattas
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
| | - Alexis Jacquier
- Departments of Radiology (A.B., A.J.) and Cardiology (G.H.), Hôpital de la Timone Adultes, AP-HM, 264, rue Saint-Pierre 13385 Marseille Cedex 05, France; CRMBM-UMR CNRS 7339, Medical Faculty, Aix-Marseille University, Marseille, France (A.B., J.F., Z.B., M.B., A.J.); I2M-UMR CNRS 7373, Aix-Marseille University, Centrale Marseille, Marseille, France (J.F., B.G.); ImVia Laboratory and University Hospital of Dijon, Bourgogne-Franche Comté University, Dijon, France (A.L.); Department of Radiology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France (L.B.); Department of Cardiovascular Imaging, Lille University Hospital, Lille, France (F.P.); and Department of Diagnostic Imaging, Rouen University Hospital, Rouen, France (J.N.D.)
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Massire A, Seiler C, Troalen T, Girard OM, Lehmann P, Brun G, Bartoli A, Audoin B, Bartolomei F, Pelletier J, Callot V, Kober T, Ranjeva JP, Guye M. T1-Based Synthetic Magnetic Resonance Contrasts Improve Multiple Sclerosis and Focal Epilepsy Imaging at 7 T. Invest Radiol 2021; 56:127-133. [PMID: 32852445 DOI: 10.1097/rli.0000000000000718] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/25/2022]
Abstract
OBJECTIVES Ultra-high field magnetic resonance imaging (MRI) (≥7 T) is a unique opportunity to improve the clinical diagnosis of brain pathologies, such as multiple sclerosis or focal epilepsy. However, several shortcomings of 7 T MRI, such as radiofrequency field inhomogeneities, could degrade image quality and hinder radiological interpretation. To address these challenges, an original synthetic MRI method based on T1 mapping achieved with the magnetization-prepared 2 rapid acquisition gradient echo (MP2RAGE) sequence was developed. The radiological quality of on-demand T1-based contrasts generated by this technique was evaluated in multiple sclerosis and focal epilepsy imaging at 7 T. MATERIALS AND METHODS This retrospective study was carried out from October 2017 to September 2019 and included 21 patients with different phenotypes of multiple sclerosis and 35 patients with focal epilepsy who underwent MRI brain examinations using a whole-body investigative 7 T magnetic resonance system. The quality of 2 proposed synthetic contrast images were assessed and compared with conventional images acquired at 7 T using the MP2RAGE sequence by 4 radiologists, evaluating 3 qualitative criteria: signal homogeneity, contrast intensity, and lesion visualization. Statistical analyses were performed on reported quality scores using Wilcoxon rank tests and further multiple comparisons tests. Intraobserver and interobserver reliabilities were calculated as well. RESULTS Radiological quality scores were reported higher for synthetic images when compared with original images, regardless of contrast, pathologies, or raters considered, with significant differences found for all 3 criteria (P < 0.0001, Wilcoxon rank test). None of the 4 radiologists ever rated a synthetic image "markedly worse" than an original image. Synthetic images were rated slightly less satisfying for only 3 epileptic patients, without precluding lesion identification. CONCLUSION T1-based synthetic MRI with the MP2RAGE sequence provided on-demand contrasts and high-quality images to the radiologist, facilitating lesion visualization in multiple sclerosis and focal epilepsy, while reducing the magnetic resonance examination total duration by removing an additional sequence.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Fabrice Bartolomei
- Pôle de Neurosciences Cliniques, Service de Neurophysiologie, APHM, Hôpital de la Timone, Marseille, France
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Collins T, Pizarro D, Gasparini S, Bourdel N, Chauvet P, Canis M, Calvet L, Bartoli A. Augmented Reality Guided Laparoscopic Surgery of the Uterus. IEEE Trans Med Imaging 2021; 40:371-380. [PMID: 32986548 DOI: 10.1109/tmi.2020.3027442] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A major research area in Computer Assisted Intervention (CAI) is to aid laparoscopic surgery teams with Augmented Reality (AR) guidance. This involves registering data from other modalities such as MR and fusing it with the laparoscopic video in real-time, to reveal the location of hidden critical structures. We present the first system for AR guided laparoscopic surgery of the uterus. This works with pre-operative MR or CT data and monocular laparoscopes, without requiring any additional interventional hardware such as optical trackers. We present novel and robust solutions to two main sub-problems: the initial registration, which is solved using a short exploratory video, and update registration, which is solved with real-time tracking-by-detection. These problems are challenging for the uterus because it is a weakly-textured, highly mobile organ that moves independently of surrounding structures. In the broader context, our system is the first that has successfully performed markerless real-time registration and AR of a mobile human organ with monocular laparoscopes in the OR.
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Castelli M, Maurin A, Bartoli A, Dassa M, Marchi B, Finance J, Lagier JC, Million M, Parola P, Brouqui P, Raoult D, Cortaredona S, Jacquier A, Gaubert JY, Habert P. Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19. Insights Imaging 2020; 11:117. [PMID: 33201409 PMCID: PMC7670109 DOI: 10.1186/s13244-020-00939-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/30/2020] [Indexed: 12/02/2022] Open
Abstract
Background Low-dose chest CT (LDCT) showed high sensitivity and ability to quantify lung involvement of COVID-19 pneumopathy. The aim of this study was to describe the prevalence and risk factors for lung involvement in 247 patients with a visual score and assess the prevalence of incidental findings. Methods For 12 days in March 2020, 250 patients with RT-PCR positive tests and who underwent LDCT were prospectively included. Clinical and imaging findings were recorded. The extent of lung involvement was quantified using a score ranging from 0 to 40. A logistic regression model was used to explore factors associated with a score ≥ 10. Results A total of 247 patients were analyzed; 138 (54%) showed lung involvement. The mean score was 4.5 ± 6.5, and the mean score for patients with lung involvement was 8.1 ± 6.8 [1–31]. The mean age was 43 ± 15 years, with 121 males (48%) and 17 asymptomatic patients (7%). Multivariate analysis showed that age > 54 years (odds ratio 4.4[2.0–9.6] p < 0.001) and diabetes (4.7[1.0–22.1] p = 0.049) were risk factors for a score ≥ 10. Multivariate analysis including symptoms showed that only age > 54 years (4.1[1.7–10.0] p = 0.002) was a risk factor for a score ≥ 10. Rhinitis (0.3[0.1–0.7] p = 0.005) and anosmia (0.3[0.1–0.9] p = 0.043) were protective against lung involvement. Incidental imaging findings were found in 19% of patients, with a need for follow-up in 0.6%. Conclusion The prevalence of lung involvement was 54% in a predominantly paucisymptomatic population. Age ≥ 55 years and diabetes were risk factors for significant parenchymal lung involvement. Rhinitis and anosmia were protective against LDCT abnormalities.
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Affiliation(s)
- Maxime Castelli
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France
| | - Arnaud Maurin
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France
| | - Axel Bartoli
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France.,UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale - Centre d'Exploration Métaboliques par Résonance Magnétique), Assistance Publique - Hôpitaux de Marseille, Aix-Marseille Université, 13385, Marseille, France
| | - Michael Dassa
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France
| | - Baptiste Marchi
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France
| | | | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Marseille, France.,IRD, APHM, Aix Marseille Univ, MEPHI, Marseille, France
| | - Matthieu Million
- IHU-Méditerranée Infection, Marseille, France.,IRD, APHM, Aix Marseille Univ, MEPHI, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France.,IRD, APHM, Aix Marseille Univ, VITROME, Marseille, SSA, France
| | - Philippe Brouqui
- IHU-Méditerranée Infection, Marseille, France.,IRD, APHM, Aix Marseille Univ, MEPHI, Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France.,IRD, APHM, Aix Marseille Univ, MEPHI, Marseille, France
| | - Sebastien Cortaredona
- IHU-Méditerranée Infection, Marseille, France.,IRD, APHM, Aix Marseille Univ, VITROME, Marseille, SSA, France
| | - Alexis Jacquier
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France.,UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale - Centre d'Exploration Métaboliques par Résonance Magnétique), Assistance Publique - Hôpitaux de Marseille, Aix-Marseille Université, 13385, Marseille, France
| | - Jean-Yves Gaubert
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France.,LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France
| | - Paul Habert
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, 264 Rue Saint Pierre, 13005, Marseille 05, France. .,LIIE, Aix Marseille Univ, Marseille, France. .,CERIMED, Aix Marseille Univ, Marseille, France.
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Leger T, Jacquier A, Barral PA, Castelli M, Finance J, Lagier JC, Million M, Parola P, Brouqui P, Raoult D, Bartoli A, Gaubert JY, Habert P. Low-dose chest CT for diagnosing and assessing the extent of lung involvement of SARS-CoV-2 pneumonia using a semi quantitative score. PLoS One 2020; 15:e0241407. [PMID: 33141845 PMCID: PMC7608883 DOI: 10.1371/journal.pone.0241407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/12/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The purpose is to assess the ability of low-dose CT (LDCT) to determine lung involvement in SARS-CoV-2 pneumonia and to describe a COVID19-LDCT severity score. MATERIALS AND METHODS Patients with SARS-CoV-2 infection confirmed by RT-PCR were retrospectively analysed. Clinical data, the National Early Warning Score (NEWS) and imaging features were recorded. Lung features included ground-glass opacities (GGO), areas of consolidation and crazy paving patterns. The COVID19-LDCT score was calculated by summing the score of each segment from 0 (no involvement) to 10 (severe impairment). Univariate analysis was performed to explore predictive factor of high COVID19-LDCT score. The nonparametric Mann-Whitney test was used to compare groups and a Spearman correlation used with p<0.05 for significance. RESULTS Eighty patients with positive RT-PCR were analysed. The mean age was 55 years ± 16, with 42 males (53%). The most frequent symptoms were fever (60/80, 75%) and cough (59/80, 74%), the mean NEWS was 1.7±2.3. All LDCT could be analysed and 23/80 (28%) were normal. The major imaging finding was GGOs in 56 cases (67%). The COVID19-LDCT score (mean value = 19±29) was correlated with NEWS (r = 0.48, p<0.0001). No symptoms were risk factor to have pulmonary involvement. Univariate analysis shown that dyspnea, high respiratory rate, hypertension and diabetes are associated to a COVID19-LDCT score superior to 50. CONCLUSIONS COVID19-LDCT score did correlate with NEWS. It was significantly different in the clinical low-risk and high-risk groups. Further work is needed to validate the COVID19-LDCT score against patient prognosis.
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Affiliation(s)
- Thomas Leger
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Alexis Jacquier
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, UMR 7339, CNRS, Centre de Résonance Magnétique Biologique et Médicale–Centre d’Exploration Métaboliques par Résonance Magnétique, Assistance Publique—Hôpitaux de Marseille, Marseille, France
| | - Pierre-Antoine Barral
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Maxime Castelli
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | | | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Matthieu Million
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, APHM, SSA, VITROME, Marseille, France
| | - Philippe Brouqui
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Axel Bartoli
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, UMR 7339, CNRS, Centre de Résonance Magnétique Biologique et Médicale–Centre d’Exploration Métaboliques par Résonance Magnétique, Assistance Publique—Hôpitaux de Marseille, Marseille, France
| | - Jean-Yves Gaubert
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- Aix Marseille Univ, LIIE, Marseille, France
- Aix Marseille Univ, CERIMED, Marseille, France
| | - Paul Habert
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- Aix Marseille Univ, LIIE, Marseille, France
- Aix Marseille Univ, CERIMED, Marseille, France
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Capron T, Cautela J, Scemama U, Miola C, Bartoli A, Theron A, Pinto J, Porto A, Collart F, Lepidi H, Bernard M, Guye M, Thuny F, Avierinos JF, Jacquier A. Cardiac magnetic resonance assessment of left ventricular dilatation in chronic severe left-sided regurgitations: comparison with standard echocardiography. Diagn Interv Imaging 2020; 101:657-665. [DOI: 10.1016/j.diii.2020.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/05/2020] [Accepted: 04/18/2020] [Indexed: 12/19/2022]
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Dacher JN, Gandjbakhch E, Taieb J, Chauvin M, Anselme F, Bartoli A, Boyer L, Cassagnes L, Cochet H, Dubourg B, Fauchier L, Gras D, Klug D, Laurent G, Mansourati J, Marijon E, Maury P, Piot O, Pontana F, Sacher F, Sadoul N, Boveda S, Jacquier A. Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology (SFC) and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) on magnetic resonance imaging in patients with cardiac electronic implantable devices. Diagn Interv Imaging 2020; 101:507-517. [PMID: 32094095 DOI: 10.1016/j.diii.2020.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/28/2020] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 11/15/2022]
Abstract
Magnetic resonance imaging (MRI) has become the reference imaging for the management of a large number of diseases. The number of MR examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). A CEID was considered an absolute contraindication for MRI for years. The progressive replacement of conventional pacemakers and defibrillators by MR-conditional CEIDs and recent data on the safety of MRI in patients with "MR-nonconditional" CEIDs have progressively increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with "MR-conditional" devices because these devices are not "MR-safe". A specific programing of the device in "MR-mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) describes the effect and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional nonguaranteed" and MR-nonconditional devices.
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Affiliation(s)
- J-N Dacher
- Normandie UNIV, UNIROUEN, Inserm U1096, CHU Rouen, Department of Radiology, Cardiac Imaging Unit, 76000 Rouen, France.
| | - E Gandjbakhch
- Sorbonne Universités, AP-HP, Heart Institute, La Pitié-Salpêtrière University Hospital, 75013 Paris, France
| | - J Taieb
- Hospital of Aix-en-Provence, Department of Cardiology, 13100 Aix-en-Provence, France
| | - M Chauvin
- Université de Strasbourg, CHU Strasbourg, Department of Cardiology, 67000 Strasbourg, France
| | - F Anselme
- Normandie UNIV, UNIROUEN, CHU Rouen, Department of Cardiology, 76000 Rouen, France
| | - A Bartoli
- Université Aix-Marseille, Centre Hospitalo-Universitaire Timone, AP-HM, Department of Radiology, CNRS, CRMBM, CEMEREM, 13005 Marseille, France
| | - L Boyer
- Université Clermont Auvergne, CHU Clermont-Ferrand, Department of Radiology, 63000 Clermont-Ferrand, France
| | - L Cassagnes
- Université Clermont Auvergne, CHU Clermont-Ferrand, Department of Radiology, 63000 Clermont-Ferrand, France
| | - H Cochet
- Université de Bordeaux-Inserm, IHU LIRYC, CHU de Bordeaux, Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, 33600 Pessac, France
| | - B Dubourg
- Normandie UNIV, UNIROUEN, Inserm U1096, CHU Rouen, Department of Radiology, Cardiac Imaging Unit, 76000 Rouen, France
| | - L Fauchier
- Université de Tours, CHU de Tours, Department of Cardiology, 37000 Tours, France
| | - D Gras
- Nouvelles Cliniques Nantaises, Department of Cardiology, 44200 Nantes, France
| | - D Klug
- Université de Lille, CHRU de Lille, Department of Cardiology, 59000 Lille, France
| | - G Laurent
- Université de Dijon, CHU de Dijon, Department of Cardiology, 21000 Dijon, France
| | - J Mansourati
- Université de Bretagne Occidentale, CHU de Brest, Department of Cardiology, 29200 Brest, France
| | - E Marijon
- Université de Paris, AP-HP, Department of Cardiology, Georges-Pompidou European University Hospital, 75015 Paris, France
| | - P Maury
- Université de Toulouse, Inserm U1048, Department of Cardiology, Hospital Rangueil, 31059 Toulouse, France
| | - O Piot
- Centre Cardiologique du Nord, Department of Cardiology, 93200 Saint-Denis, France
| | - F Pontana
- Université de Lille, Inserm U1011, Department of Cardiovascular Radiology, Institut Cœur-Poumon, 59000 Lille, France
| | - F Sacher
- Université de Bordeaux-Inserm, IHU LIRYC, CHU de Bordeaux, Department of Cardiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France
| | - N Sadoul
- Université de Nancy Lorraine, CHU de Nancy, Department of Cardiology, 54511 Vandœuvre-lès-Nancy, France
| | - S Boveda
- Clinique Pasteur, Department of Cardiology, 31076 Toulouse, France
| | - A Jacquier
- Université Aix-Marseille, Centre Hospitalo-Universitaire Timone, AP-HM, Department of Radiology, CNRS, CRMBM, CEMEREM, 13005 Marseille, France
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Foussier C, Barral PA, Jerosh-Herold M, Gariboldi V, Rapacchi S, Gallon A, Bartoli A, Bentatou Z, Guye M, Bernard M, Jacquier A. Quantification of diffuse myocardial fibrosis using CMR extracellular volume fraction and serum biomarkers of collagen turnover with histologic quantification as standard of reference. Diagn Interv Imaging 2020; 102:163-169. [PMID: 32830084 DOI: 10.1016/j.diii.2020.07.005] [Citation(s) in RCA: 4] [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: 02/20/2020] [Revised: 06/16/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare the assessment of diffuse interstitial myocardial fibrosis in valvular diseases using cardiac magnetic resonance (CMR) extracellular volume fraction (ECV) quantification and serum biomarkers of collagen turnover using results of myocardial biopsy as standard of reference. MATERIALS AND METHODS This prospective monocentric study included consecutive patients before aortic valvular replacement. All patients underwent: i), 1.5T CMR with pre and post contrast T1 mapping sequence and ECV computation; ii), serum quantification of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) and iii), myocardial biopsies were collected during surgery to assess collagen volume fraction (CVF). Patients with coronary artery disease were excluded. Correlation between native T1, ECV, CVF and serum biomarkers were assessed using Pearson correlation test. Agreement between basal anteroseptal ECV with global ECV was assessed using Bland-Altman test. RESULTS Twenty-one patients, 16 with aortic stenosis and 5 with aortic regurgitation were included. There were 12 men and 9 women with a mean age of 74.1±6.8 (SD) years (range: 32-84 years). Mean global ECV value was 26.7±2.7 (SD) % (range: 23.4-32.5%) and mean CVF value was 12.4±9.7% (range: 3.2-25.7%). ECV assessed at the basal anteroseptal segment correlated moderately with CVF (r=0.6; P=0.0026). There was a strong correlation and agreement between basal anteroseptal ECV and global ECV, (r=0.8; P<0.0001; bias 5.4±6.1%) but no correlation between global ECV and CVF (r=0.5; P=0.10). Global ECV poorly correlated with serum TIMP-1 (r=0.4; P=0.037) and MMP-2 (r=0.4; P=0.047). No correlation was found between serum biomarkers and basal anteroseptal- ECV or native T1. CONCLUSION In patients with severe aortic valvulopathy, diffuse myocardial fibrosis assessed by anterosepto-basal ECV correlates with histological myocardial fibrosis. Anteroseptobasal ECV strongly correlates with global ECV, which poorly correlates with TIMP-1 and MMP-2, serum biomarkers involved in the progression of heart failure.
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Affiliation(s)
- C Foussier
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France; UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - P A Barral
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France; UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - M Jerosh-Herold
- Non-Invasive Cardiovascular Imaging Section, Brigham and Women's Hospital, Boston, MA 02215, USA
| | - V Gariboldi
- Department of Heart Surgery, Hôpital de la Timone, 13385 Marseille cedex 05, France
| | - S Rapacchi
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - A Gallon
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France
| | - A Bartoli
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France
| | - Z Bentatou
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - M Guye
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France
| | - M Bernard
- UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France; Aix-Marseille Univ, CNRS, CRMBM, 13000 Marseille, France
| | - A Jacquier
- Department of Radiology, Hôpital de la Timone, 13385 Marseille, France; UMR CNRS 7339, Aix-Marseille University, 13385 Marseille, France; Centre de Résonance Magnétique Biologique et Médicale, Hôpital de la Timone, AP-HM, 13385 Marseille cedex 05, France.
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Gandjbakhch E, Dacher JN, Taieb J, Chauvin M, Anselme F, Bartoli A, Boyer L, Cassagnes L, Cochet H, Defaye P, Deharo JC, Dubourg B, Fauchier L, Gras D, Klug D, Laurent G, Mansourati J, Marijon E, Maury P, Piot O, Pontana F, Sacher F, Sadoul N, Jacquier A, Boveda S. Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the French Society of Diagnostic and Interventional Cardiac and Vascular Imaging on magnetic resonance imaging in patients with cardiac electronic implantable devices. Arch Cardiovasc Dis 2020; 113:473-484. [DOI: 10.1016/j.acvd.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
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Habert P, Capron T, Hubert S, Bentatou Z, Bartoli A, Tradi F, Renard S, Rapacchi S, Guye M, Bernard M, Habib G, Jacquier A. Quantification of right ventricular extracellular volume in pulmonary hypertension using cardiac magnetic resonance imaging. Diagn Interv Imaging 2020; 101:311-320. [DOI: 10.1016/j.diii.2019.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 12/30/2022]
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Habert P, Hak JF, Di Bisceglie M, Bartoli A, Gaubert JY, Vidal V, Tradi F. [Central venous access in interventional radiology]. Presse Med 2019; 48:1141-1145. [PMID: 31669005 DOI: 10.1016/j.lpm.2019.10.013] [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: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022] Open
Abstract
Some patients require iteratives intravenous administrations on a central catheter, for example in oncology or infectiology, which represents a challenge for ambulatory treatment. Interventional radiology could provide solutions with the implant and monitoring of PICC-lines and ports. These are implanted in sterile environment and under imaging guidance in an interventional radiology room by an operator and with a paramedical team that need to be experienced. This development focus on the interest of one method with respect to the other, as well as the differents ways to do, the complications that could arise and the monitoring of these devices.
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Affiliation(s)
- Paul Habert
- AP-HM, hôpital La Timone, service de radiologie interventionnelle, 265, rue Saint-Pierre, 13005 Marseille, France; Aix-Marseille université, LIIE, Marseille, France; Aix-Marseille université, CERIMED, Marseille, France.
| | - Jean-François Hak
- AP-HM, hôpital La Timone, service de radiologie interventionnelle, 265, rue Saint-Pierre, 13005 Marseille, France; Aix-Marseille université, LIIE, Marseille, France; Aix-Marseille université, CERIMED, Marseille, France
| | - Mathieu Di Bisceglie
- AP-HM, hôpital La Timone, service de radiologie interventionnelle, 265, rue Saint-Pierre, 13005 Marseille, France; Aix-Marseille université, LIIE, Marseille, France; Aix-Marseille université, CERIMED, Marseille, France
| | - Axel Bartoli
- AP-HM, hôpital La Timone, service de radiologie interventionnelle, 265, rue Saint-Pierre, 13005 Marseille, France; Aix-Marseille université, LIIE, Marseille, France; Aix-Marseille université, CERIMED, Marseille, France
| | - Jean-Yves Gaubert
- AP-HM, hôpital La Timone, service de radiologie interventionnelle, 265, rue Saint-Pierre, 13005 Marseille, France; Aix-Marseille université, LIIE, Marseille, France; Aix-Marseille université, CERIMED, Marseille, France
| | - Vincent Vidal
- AP-HM, hôpital La Timone, service de radiologie interventionnelle, 265, rue Saint-Pierre, 13005 Marseille, France; Aix-Marseille université, LIIE, Marseille, France; Aix-Marseille université, CERIMED, Marseille, France
| | - Farouk Tradi
- AP-HM, hôpital La Timone, service de radiologie interventionnelle, 265, rue Saint-Pierre, 13005 Marseille, France; Aix-Marseille université, LIIE, Marseille, France; Aix-Marseille université, CERIMED, Marseille, France
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Ratto F, Schiavinato DJ, Bartoli A. Tipificación en <em>Gutierrezia</em> (Asteraceae, Astereae). Collect Bot 2019. [DOI: 10.3989/collectbot.2019.v38.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Durante el transcurso de la revisión de las especies sudamericanas de Gutierrezia, hemos podido hallar nombres que requieren tipificación. Luego del análisis de los protologos y especímenes de herbario, hemos designado ocho lectótipos y un neótipo para nueve nombres del género Gutierrezia. Además, se asignó la categoría de hólotipo a un especimen. Se provee una discusión detallada para cada nombre.
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Toti MS, Ghirri P, Bartoli A, Caputo C, Laudani E, Masoni F, Mele L, Bernardini R. Adrenal hemorrhage in newborn: how, when and why- from case report to literature review. Ital J Pediatr 2019; 45:58. [PMID: 31068206 PMCID: PMC6507044 DOI: 10.1186/s13052-019-0651-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 10/16/2018] [Accepted: 04/18/2019] [Indexed: 12/01/2022] Open
Abstract
Background Neonatal adrenal hemorrhage is a relatively uncommon condition (0.2–0.55%). Various risk factors have been reported in addition to birth asphyxia, such as sepsis, coagulation disorders, traumatic delivery, and perinatal injuries. Adrenal hemorrhage usually affects the right adrenal gland (about 70% of cases) while it involves the bilateral adrenal gland only in 10% of cases. In most cases, the event is asymptomatic but, in others, it may be so devastating to determine death by bleeding or adrenal insufficiency. Case presentation A case of bilateral neonatal adrenal hemorrhage, with adrenal insufficiency, but with no important risk factors and favorable evolution in a male infant. Conclusions This case emphasizes the importance of keeping a non-interventional attitude, avoiding early surgery but carrying out a serial sonographic follow-up. Serial ultrasound monitoring is the most reliable approach during conservative management. Electronic supplementary material The online version of this article (10.1186/s13052-019-0651-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M S Toti
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy.
| | - P Ghirri
- Neonatology and Neonatal Intensive Care Unit, Santa Chiara University Hospital, Pisa, Italy
| | - A Bartoli
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - C Caputo
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - E Laudani
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - F Masoni
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - L Mele
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - R Bernardini
- Pediatric Unit, San Giuseppe Hospital, Empoli, Florence, Italy
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Habert P, Bentatou Z, Aldebert P, Finas M, Bartoli A, Bal L, Lalande A, Rapacchi S, Guye M, Kober F, Bernard M, Jacquier A. Exercise stress CMR reveals reduced aortic distensibility and impaired right-ventricular adaptation to exercise in patients with repaired tetralogy of Fallot. PLoS One 2018; 13:e0208749. [PMID: 30596647 PMCID: PMC6312273 DOI: 10.1371/journal.pone.0208749] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 11/21/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of our study was to evaluate the feasibility of exercise cardiac magnetic resonance (CMR) in patients with repaired tetralogy of Fallot (RTOF) and to assess right and left ventricular adaptation and aortic wall response to exercise in comparison with volunteers. METHODS 11 RTOF and 11 volunteers underwent prospective CMR at rest and during exercise. A supine bicycle ergometer was employed to reach twice the resting heart rate during continuous exercise, blood pressure and heart rate were recorded. Bi-ventricular parameters and aortic stiffness were assessed using accelerated cine sequences and flow-encoding CMR. A t-test was used to compare values between groups. A Mann Whitney test was used to compare values within groups. RESULTS In RTOF both ventricles showed an impaired contractile reserve (RVEF rest 36.2±8.3%, +1.3±3.9% increase after exercise; LVEF rest 53.8±6.1%, +5.7±6.4% increase after exercise) compared to volunteers (RVEF rest 50.5±5.0%, +10.4±7.1% increase after exercise, p = 0.039; LVEF rest 61.9±3.1%, +12.2±4.7% increase after exercise, p = 0.014). RTOF showed a reduced distensibility of the ascending aorta during exercise compared to volunteers (RTOF: 3.4±1.9 10-3.mmHg-1 vs volunteers: 5.1±1.4 10-3.mmHg-1; p = 0.027). Ascending aorta distensibility was correlated to cardiac work in the volunteers but not in RTOF. CONCLUSION RTOF showed an impaired contractile reserve for both ventricles. The exercise unmasked a reduced distensibility of the ascending aorta in RTOF, which may be an early sign of increased aortic rigidity.
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Affiliation(s)
- Paul Habert
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Radiology and Cardiovascular Imaging, La Timone Hospital, Marseille, France
- * E-mail:
| | | | - Philippe Aldebert
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Cardiology and Department of Infectious Diseases, La Timone Hospital, Marseille, France
| | | | - Axel Bartoli
- Department of Radiology and Cardiovascular Imaging, La Timone Hospital, Marseille, France
| | - Laurence Bal
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Vascular Surgery and Vascular Medicine, La Timone Hospital, Marseille, France
| | - Alain Lalande
- LE2I, UMR 6306 CNRS, University of Burgundy, Dijon, France
- MRI Department, University Hospital of Dijon, Dijon, France
| | | | - Maxime Guye
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
| | - Frank Kober
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
| | | | - Alexis Jacquier
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
- Department of Radiology and Cardiovascular Imaging, La Timone Hospital, Marseille, France
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Talamonti C, Bartoli A, Scaringella M, Baldi A, Masi L, Pallotta S, Bruzzi M. 213. Pre-treatment verification of stereotactic plans using a bi-dimensional diamond detector. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Bartoli A, King A, Hornberger K, Klepacka D, Young D, Schoolcraft W, Katz-Jaffe M. The impact of aneuploidy screening for embryo selection in preimplantation genetic testing for monogenenic disorders. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hornberger K, Bartoli A, King A, Bachman N, Young D, Klepacka D, Schoolcraft W, Katz-Jaffe M. Maternal obesity is not associated with increased miscarriage rates following euploid blastocyst transfer. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bourdel N, Collins T, Pizarro D, Chauvet P, Debize C, Bartoli A, Canis M. First Use of Augmented Reality in Gynecology. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bourdel N, Collins T, Pizarro D, Pereira B, Canis M, Bartoli A. Augmented Reality Evaluation of Potential Benefits for Myomectomy in an Experimental Uterine Model. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Talamonti C, Falco M, Bartoli A, Russo S, Iervolino C, Menghi E, Moretti E, Mones E, Fiandra C, Casale M, Pastore G, Oliviero C, DiCastro E, Luxardo S, Vaiano A, Raza G, Borzi G, Carbonini C, Consorti R, Pressello M, Gasperi C, Tonghi LB, Palleri F, Marino C, Ardu V, Linsalata S, Riccardi S, Vittorini F, Spiazzi L, Rosica F, Iervolino C, Villaggi E, Mancosu P. Small field relative dosimetry using a silicon diode of new generation. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Se describe e ilustra Gutierrezia tortosae Ratto & Adr. Bartoli, una nueva especie de Argentina. Se asemeja a Gutierrezia mandonii (Sch. Bip.) Solbrig por presentar xilopodio, por la forma de las hojas y por el color amarillo de las flores liguladas, pero difiere de ella por tener tallos erectos y rígidos, hojas erectas y capítulos menores. Se presenta una clave para diferenciarla de las especies que habitan en el noroeste de Argentina.
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