1
|
Wendling D, Tabaa OA, Chevet B, Fakih O, Ghossan R, Hecquet S, Dernis E, Maheu E, Saraux A, Besson FL, Alegria GC, Cortet B, Fautrel B, Felten R, Morel J, Ottaviani S, Querellou-Lefranc S, Ramon A, Ruyssen-Witrand A, Seror R, Tournadre A, Foulquier N, Verlhac B, Verhoeven F, Devauchelle-Pensec V. Recommendations of the French Society of Rheumatology for the management in current practice of patients with Polymyalgia Rheumatica. Joint Bone Spine 2024:105730. [PMID: 38583691 DOI: 10.1016/j.jbspin.2024.105730] [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: 02/17/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To develop recommendations for the routine management of patients with polymyalgia rheumatica (PMR) Methods: Following standard procedures, a systematic review of the literature by 5 supervised junior rheumatologists, based on the questions selected by the steering committee (5 senior rheumatologists), was used as the basis for working meetings, followed by a one-day plenary meeting with the working group (15 members), leading to the development of the wording and determination of the strength of the recommendations and the level of agreement of the experts. RESULTS Five general principles and 19 recommendations were drawn up. Three recommendations relate to diagnosis and the use of imaging, and 5 to the assessment of the disease, its activity and co-morbidities. Non-pharmacological therapies are the subject of one recommendation. Three recommendations concern initial treatment based on general corticosteroid therapy, 5 concern the reduction of corticosteroid therapy and follow-up, and 2 concern corticosteroid dependence and steroid-sparing treatments (anti-IL-6). CONCLUSION These recommendations take account of current data on PMR, with the aim of reducing exposure to corticosteroid therapy and its side effects in a fragile population. They are intended to be practical, to help practitioners in the day-to-day management of patients with PMR.
Collapse
Affiliation(s)
- Daniel Wendling
- Rhumatologie, CHU de Besançon et Université de Franche-Comté, Besançon, France.
| | - Omar Al Tabaa
- Rhumatologie, Hôpital Cochin, AP-HP, Paris, France; Rhumatologie, Hôpital NOVO, Pontoise, France
| | - Baptiste Chevet
- Université de Bretagne Occidentale (Univ Brest), Department of Rheumatology, CHU Brest, INSERM (U1227), LabEx IGO, Brest, France, 29200 Brest, France
| | - Olivier Fakih
- Rhumatologie, CHU de Besançon et Université de Franche-Comté, Besançon, France
| | - Roba Ghossan
- Rhumatologie, Hôpital Cochin, AP-HP, Paris, France
| | | | | | - Emmanuel Maheu
- Service de Rhumatologie, Hôpital St Antoine, APHP, et cabinet médical, Paris, France
| | - Alain Saraux
- Université de Bretagne Occidentale (Univ Brest), Department of Rheumatology, CHU Brest, INSERM (U1227), LabEx IGO, Brest, France, 29200 Brest, France
| | - Florent L Besson
- Service de Médecine Nucléaire-Imagerie Moléculaire, Hôpitaux Universitaires Paris-Saclay AP-HP, CHU Bicêtre, DMU SMART IMAGING, Le Kremlin-Bicêtre, France
| | | | - Bernard Cortet
- Service de Rhumatologie, CHU de Lille, 59037 Lille, France
| | - Bruno Fautrel
- AP-HP.Sorbonne Université, Service de Rhumatologie,GH Pitié Salpêtrière, INSERM UMRS 1136-5, Réseau de Recherche Clinique CRI-IMIDIATE, 75013 Paris, France
| | - Renaud Felten
- Service de Rhumatologie et Centre d'Investigation Clinique 1434, Hôpitaux Universitaires de Strasbourg, France
| | - Jacques Morel
- Service de Rhumatologie. CHU et Université de Montpellier, Montpellier, France
| | | | - Solène Querellou-Lefranc
- Nuclear Medicine department, University Hospital, Brest, France, University of Western Brittany (UBO), Brest, France, Inserm, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest cedex, France
| | - André Ramon
- Service de Rhumatologie, CHU Dijon Bourgogne, Dijon, France
| | - Adeline Ruyssen-Witrand
- Centre de rhumatologie, CHU de Toulouse, Centre d'Investigation Clinique de Toulouse CIC1436, Inserm, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS », Université Paul Sabatier Toulouse 3, Toulouse, France
| | - Raphaèle Seror
- Service de Rhumatologie, CHU Kremlin-Bicetre, APHP, Paris, France
| | - Anne Tournadre
- Rhumatologie CHU Clermont-Ferrand, Université Clermont Auvergne INRAe, France
| | - Nathan Foulquier
- LBAI, UMR1227, Univ Brest, Inserm, Brest, France ; CHU de Brest, Brest, France
| | | | - Frank Verhoeven
- Rhumatologie, CHU de Besançon et Université de Franche-Comté, Besançon, France
| | - Valérie Devauchelle-Pensec
- Université de Bretagne Occidentale (Univ Brest), Department of Rheumatology, CHU Brest, INSERM (U1227), LabEx IGO, Brest, France, 29200 Brest, France.
| |
Collapse
|
2
|
Besson FL, Faure S. PET KinetiX-A Software Solution for PET Parametric Imaging at the Whole Field of View Level. J Imaging Inform Med 2024; 37:842-850. [PMID: 38343229 PMCID: PMC11031504 DOI: 10.1007/s10278-023-00965-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 04/20/2024]
Abstract
Kinetic modeling represents the ultimate foundations of PET quantitative imaging, a unique opportunity to better characterize the diseases or prevent the reduction of drugs development. Primarily designed for research, parametric imaging based on PET kinetic modeling may become a reality in future clinical practice, enhanced by the technical abilities of the latest generation of commercially available PET systems. In the era of precision medicine, such paradigm shift should be promoted, regardless of the PET system. In order to anticipate and stimulate this emerging clinical paradigm shift, we developed a constructor-independent software package, called PET KinetiX, allowing a faster and easier computation of parametric images from any 4D PET DICOM series, at the whole field of view level. The PET KinetiX package is currently a plug-in for Osirix DICOM viewer. The package provides a suite of five PET kinetic models: Patlak, Logan, 1-tissue compartment model, 2-tissue compartment model, and first pass blood flow. After uploading the 4D-PET DICOM series into Osirix, the image processing requires very few steps: the choice of the kinetic model and the definition of an input function. After a 2-min process, the PET parametric and error maps of the chosen model are automatically estimated voxel-wise and written in DICOM format. The software benefits from the graphical user interface of Osirix, making it user-friendly. Compared to PMOD-PKIN (version 4.4) on twelve 18F-FDG PET dynamic datasets, PET KinetiX provided an absolute bias of 0.1% (0.05-0.25) and 5.8% (3.3-12.3) for KiPatlak and Ki2TCM, respectively. Several clinical research illustrative cases acquired on different hybrid PET systems (standard or extended axial fields of view, PET/CT, and PET/MRI), with different acquisition schemes (single-bed single-pass or multi-bed multipass), are also provided. PET KinetiX is a very fast and efficient independent research software that helps molecular imaging users easily and quickly produce 3D PET parametric images from any reconstructed 4D-PET data acquired on standard or large PET systems.
Collapse
Affiliation(s)
- Florent L Besson
- Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, AP-HP, DMU SMART IMAGING, CHU Bicêtre, Le Kremlin-Bicêtre, France.
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
- CEA / Inserm / CNRS/ Université Paris-Saclay, BioMaps, Orsay, France.
| | - Sylvain Faure
- Laboratoire de Mathématique d'Orsay, CNRS, Université Paris-Saclay, Orsay, France
| |
Collapse
|
3
|
Besson FL, Treglia G, Bucerius J, Anagnostopoulos C, Buechel RR, Dweck MR, Erba PA, Gaemperli O, Gimelli A, Gheysens O, Glaudemans AWJM, Habib G, Hyafil F, Lubberink M, Rischpler C, Saraste A, Slart RHJA. A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06597-x. [PMID: 38221570 DOI: 10.1007/s00259-024-06597-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: 11/05/2023] [Accepted: 01/01/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study aimed to evaluate the level of evidence of expert recommendations and guidelines for clinical indications and procedurals in hybrid nuclear cardiovascular imaging. METHODS From inception to August 2023, a PubMed literature analysis of the latest version of guidelines for clinical hybrid cardiovascular imaging techniques including SPECT(/CT), PET(/CT), and PET(/MRI) was performed in two categories: (1) for clinical indications for all-in primary diagnosis; subgroup in prognosis and therapy evaluation; and for (2) imaging procedurals. We surveyed to what degree these followed a standard methodology to collect the data and provide levels of evidence, and for which topic systematic review evidence was executed. RESULTS A total of 76 guidelines, published between 2013 and 2023, were included. The evidence of guidelines was based on systematic reviews in 7.9% of cases, non-systematic reviews in 47.4% of cases, a mix of systematic and non-systematic reviews in 19.7%, and 25% of guidelines did not report any evidence. Search strategy was reported in 36.8% of cases. Strengths of recommendation were clearly reported in 25% of guidelines. The notion of external review was explicitly reported in 23.7% of cases. Finally, the support of a methodologist was reported in 11.8% of the included guidelines. CONCLUSION The use of evidence procedures for developing for evidence-based cardiovascular hybrid imaging recommendations and guidelines is currently suboptimal, highlighting the need for more standardized methodological procedures.
Collapse
Affiliation(s)
- Florent L Besson
- Department of Nuclear Medicine-Molecular Imaging, DMU SMART IMAGING, Hôpitaux Universitaires Paris-Saclay, AP-HP, CHU Bicêtre, Le Kremlin Bicetre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicetre, France
- Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), Inserm, BioMaps, Université Paris-Saclay, Le Kremlin-Bicetre, France
| | - Giorgio Treglia
- Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6501, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
| | - Jan Bucerius
- Department of Nuclear Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Gottingen, Germany
| | | | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK
| | - Paula A Erba
- Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Institut Roi Albert II, Université Catholique de Louvain, 1200, Brussels, Belgium
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gilbert Habib
- Department of Cardiology, APHM, La Timone Hospital, Marseille, France
| | - Fabian Hyafil
- Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, F75015, Paris, France
| | - Mark Lubberink
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | | | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
- Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands.
| |
Collapse
|
4
|
Besson FL, Mekinian A. PET FDG CT is useful for giant-cell arteritis with isolated cough. Rheumatol Int 2023; 43:2333-2336. [PMID: 37581686 DOI: 10.1007/s00296-023-05395-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
Giant cell arteritis (GCA) is a chronic vasculitis of large- and medium-sized vessels. The most frequent symptoms are temporal headaches, scalp tenderness, jaw claudication and polymyalgia rheumatica in 35% of patients. Atypical presentation with dry cough is very rare and could be isolated making the diagnosis difficult. Initial imaging including PET-CT could be helpful. Literature review yielded 13 case reports with available data and one case series which focused on cough and which were all be included in this study. Most of the cases included males (n = 8), with mostly isolated cough or associated to fever and weight loss. Angio-CT of aortic wall was mostly normal, whereas FDG PET-CT showed in all available cases abnormal arterial thoracic uptake. Temporal artery biopsy was almost suggestive of GCA in all available cases. Cough was steroid responsive usually within few days in all cases without any need of combined therapy. Giant cell arteritis is the most common large-vessel vasculitis over the age of 50 in western countries. Isolated dry cough is extremely rare and encountered in less than 5% of cases.
Collapse
Affiliation(s)
- Florent L Besson
- Nuclear Medicine Department, Kremlin Bicetre Hospital, APHP, Kremlin Bicetre, France
| | - Arsene Mekinian
- Service de Medicine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU i2), Sorbonne Université, AP-HP, Hôpital Saint-Antoine, 75012, Paris, France.
| |
Collapse
|
5
|
Gheysens O, de Ponfilly MP, Nocturne G, Seror R, Besson FL, Jamar F. [ 18F]FDG-PET/CT in Polymyalgia Rheumatica: An Update and Future Aspects. Semin Nucl Med 2023:S0001-2998(23)00083-1. [PMID: 38030423 DOI: 10.1053/j.semnuclmed.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023]
Abstract
Polymyalgia rheumatica (PMR) is an inflammatory disorder usually diagnosed in patients older than 50 years of age. It is characterized by sudden onset pain and prolonged morning stiffness in the scapular and/or pelvic girdle, sometimes debilitating and accompanied by constitutional symptoms such as weight loss. In approximately 20% of the cases, it is linked to giant cell arteritis (GCAV) representing a disease continuum. The diagnosis is mainly clinical and noninvasive imaging such as ultrasound of joints may be helpful. In atypical PMR cases, whole body imaging using [18F]FDG-PET/CT may be useful. First, to confirm or rule out the diagnosis of PMR, secondly, to assess the coexistence of a GCA, and thirdly to establish the differential diagnosis with other types of arthritides encountered in this age group, such as elderly-onset rheumatoid arthritis, spondyloarthropathies, crystal-induced arthropathies or the rare remittent seronegative symmetrical synovitis with pitting edema. Relatively typical patterns of [18F]FDG-PET/CT are well known, based on the clinical distribution of the disease (eg, scapular and pelvic girdle, interspinous bursae, sterno-costoclavicular joints, entheses), especially the hypermetabolism at the interspinous lumbar bursae that has shown the best post-test likelihood ratio in a meta-analysis. This article focuses on the differential diagnosis and on the visual and semi-quantitative tools that can be used to guide to the correct diagnosis of PMR as an add-on to the clinical picture. Further, we briefly discuss the options that can improve molecular imaging in the future for inflammatory rheumatisms in elderly.
Collapse
Affiliation(s)
- Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires St-Luc and Institute for Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Marie Péan de Ponfilly
- Department of Rheumatology, Hôpital Bicêtre Assistance Publique -Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Gaetane Nocturne
- Department of Rheumatology, Université Paris-Saclay, INSERM U1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, Paris, France
| | - Raphaële Seror
- Department of Rheumatology, Université Paris-Saclay, INSERM U1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, Paris, France
| | - Florent L Besson
- Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaire Paris-Saclay, AP-HP, DMU SMART IMAGING, CHU Bicêtre Le Kremlin-Bicêtre, France
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, Paris, France
- Université Paris-Saclay, Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Centre National de la Recherche Scientifique (CNRS), Inserm, BioMaps, Le Kremlin-Bicêtre, France
| | - François Jamar
- Department of Nuclear Medicine, Cliniques Universitaires St-Luc and Institute for Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
6
|
Besson FL, Nocturne G, Noël N, Gheysens O, Slart RHJA, Glaudemans AWJM. PET/CT in Inflammatory and Auto-immune Disorders: Focus on Several Key Molecular Concepts, FDG, and Radiolabeled Probe Perspectives. Semin Nucl Med 2023:S0001-2998(23)00084-3. [PMID: 37973447 DOI: 10.1053/j.semnuclmed.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
Chronic immune diseases mainly include autoimmune and inflammatory diseases. Managing chronic inflammatory and autoimmune diseases has become a significant public health concern, and therapeutic advancements over the past 50 years have been substantial. As therapeutic tools continue to multiply, the challenge now lies in providing each patient with personalized care tailored to the specifics of their condition, ushering in the era of personalized medicine. Precise and holistic imaging is essential in this context to comprehensively map the inflammatory processes in each patient, identify prognostic factors, and monitor treatment responses and complications. Imaging of patients with inflammatory and autoimmune diseases must provide a comprehensive view of the body, enabling the whole-body mapping of systemic involvement. It should identify key cellular players in the pathology, involving both innate immunity (dendritic cells, macrophages), adaptive immunity (lymphocytes), and microenvironmental cells (stromal cells, tissue cells). As a highly sensitive imaging tool with vectorized molecular probe capabilities, PET/CT can be of high relevance in the management of numerous inflammatory and autoimmune diseases. Relying on key molecular concepts of immunity, the clinical usefulness of FDG-PET/CT in several relevant inflammatory and immune-inflammatory conditions, validated or emerging, will be discussed in this review, together with radiolabeled probe perspectives.
Collapse
Affiliation(s)
- Florent L Besson
- Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, AP-HP, DMU SMART IMAGING, CHU Bicêtre, Paris, France; Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Université Paris-Saclay, Commissariat à l'énergie Atomique et aux Énergies Alternatives (CEA), Centre National de la Recherche Scientifique (CNRS), INSERM, BioMaps, Le Kremlin-Bicêtre, France.
| | - Gaetane Nocturne
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Department of Rheumatology, Hôpital Bicêtre Assistance Publique -Hôpitaux de Paris, Le Kremlin-Bicêtre, France; Center for Immunology of Viral Infections and Auto-Immune Diseases (IMVA), Université Paris-Saclay, Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Le Kremlin Bicêtre, Paris, France
| | - Nicolas Noël
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Center for Immunology of Viral Infections and Auto-Immune Diseases (IMVA), Université Paris-Saclay, Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Le Kremlin Bicêtre, Paris, France; Department of Internal Medicine, Hôpital Bicêtre Assistance Publique -Hôpitaux de Paris, Le Kremlin-Bicêtre, Paris, France
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires St-Luc and Institute for Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands; Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|
7
|
Cheval M, Rodrigo S, Taussig D, Caillé F, Petrescu AM, Bottlaender M, Tournier N, Besson FL, Leroy C, Bouilleret V. [ 18F]DPA-714 PET Imaging in the Presurgical Evaluation of Patients With Drug-Resistant Focal Epilepsy. Neurology 2023; 101:e1893-e1904. [PMID: 37748889 PMCID: PMC10663012 DOI: 10.1212/wnl.0000000000207811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/17/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Translocator protein 18 kDa (TSPO) PET imaging is used to monitor glial activation. Recent studies have proposed TSPO PET as a marker of the epileptogenic zone (EZ) in drug-resistant focal epilepsy (DRFE). This study aims to assess the contributions of TSPO imaging using [18F]DPA-714 PET and [18F]FDG PET for localizing the EZ during presurgical assessment of DRFE, when phase 1 presurgical assessment does not provide enough information. METHODS We compared [18F]FDG and [18F]DPA-714 PET images of 23 patients who had undergone a phase 1 presurgical assessment, using qualitative visual analysis and quantitative analysis, at both the voxel and the regional levels. PET abnormalities (increase in binding for [18F]DPA-714 vs decrease in binding for [18F]FDG) were compared with clinical hypotheses concerning the localization of the EZ based on phase 1 presurgical assessment. The additional value of [18F]DPA-714 PET imaging to [18F]FDG for refining the localization of the EZ was assessed. To strengthen the visual analysis, [18F]DPA-714 PET imaging was also reviewed by 2 experienced clinicians blind to the EZ location. RESULTS The study included 23 patients. Visual analysis of [18F]DPA-714 PET was significantly more accurate than [18F]FDG PET to both, show anomalies (95.7% vs 56.5%, p = 0.022), and provide additional information to refine the EZ localization (65.2% vs 17.4%, p = 0.019). All 10 patients with normal [18F]FDG PET had anomalies when using [18F]DPA-714 PET. The additional value of [18F]DPA-714 PET seemed to be greater in patients with normal brain MRI or with neocortical EZ (especially if insula is involved). Regional analysis of [18F]DPA-714 and [18F]FDG PET provided similar results. However, using voxel-wise analysis, [18F]DPA-714 was more effective than [18F]FDG for unveiling clusters whose localization was more often consistent with the EZ hypothesis (87.0% vs 39.1%, p = 0.019). Nonrelevant bindings were seen in 14 of 23 patients in visual analysis and 9 patients of 23 patients in voxel-wise analysis. DISCUSSION [18F]DPA-714 PET imaging provides valuable information for presurgical assessments of patients with DRFE. TSPO PET could become an additional tool to help to the localization of the EZ, especially in patients with negative [18F]FDG PET. TRIAL REGISTRATION INFORMATION Eudract 2017-003381-27. Inclusion of the first patient: September 24, 2018. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence on the utility of [18F]DPA-714 PET compared with [18F]FDG PET in identifying the epileptic zone in patients undergoing phase 1 presurgical evaluation for intractable epilepsy.
Collapse
Affiliation(s)
- Margaux Cheval
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France.
| | - Sebastian Rodrigo
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Delphine Taussig
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Fabien Caillé
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Ana Maria Petrescu
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Michel Bottlaender
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Nicolas Tournier
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Florent L Besson
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Claire Leroy
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| | - Viviane Bouilleret
- From the Université Paris-Saclay (M.C., C.L., M.B., N.T.); BioMAPS (S.R., F.C., F.L.B.); Bicetre University Hospital (D.T., A.M.P.), Paris; and Imagerie Moléculaire In Vivo (V.B.), SHFJ, CEA, Orsay, France
| |
Collapse
|
8
|
Ascione S, Harel S, Besson FL, Belkhir R, Henry J, Royer B, Arnulf B, Mariette X, Seror R. Chemotherapy in solitary bone plasmacytoma to prevent evolution to multiple myeloma. Haematologica 2023; 108:3160-3164. [PMID: 36951162 PMCID: PMC10620568 DOI: 10.3324/haematol.2022.282214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/10/2023] [Indexed: 03/24/2023] Open
Affiliation(s)
- Sophia Ascione
- Department of Rheumatology, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre
| | - Stéphanie Harel
- Department of Immunohematology, AP-HP, Hôpital Saint-Louis, Paris
| | - Florent L Besson
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401
| | - Rakiba Belkhir
- Department of Rheumatology, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre
| | - Julien Henry
- Department of Rheumatology, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre
| | - Bruno Royer
- Department of Immunohematology, AP-HP, Hôpital Saint-Louis, Paris
| | - Bertrand Arnulf
- Department of Immunohematology, AP-HP, Hôpital Saint-Louis, Paris
| | - Xavier Mariette
- Department of Rheumatology, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre, France; Center of Immunology of Viral Infections and Auto-immune Diseases (IMVA), INSERM UMR1184, Université Paris-Saclay, Le Kremlin Bicêtre
| | - Raphaèle Seror
- Department of Rheumatology, AP-HP, Hôpital Bicêtre, Le Kremlin Bicêtre, France; Center of Immunology of Viral Infections and Auto-immune Diseases (IMVA), INSERM UMR1184, Université Paris-Saclay, Le Kremlin Bicêtre.
| |
Collapse
|
9
|
Sönmez RE, Besson FL, Ghidaglia J, Lewin M, Gomez L, Salloum C, Pittau G, Ciacio O, Allard MA, Cherqui D, Adam R, Sa Cunha A, Azoulay D, Vibert E, Golse N. Towards refining the utility of dual (18F-FDG / 18F-Choline) PET/CT for the management of hepatocellular carcinoma: a tertiary center study. Q J Nucl Med Mol Imaging 2023; 67:206-214. [PMID: 36345856 DOI: 10.23736/s1824-4785.22.03485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The role of positron emission tomography/computed tomography (PET/CT) in hepatocellular carcinoma (HCC) management is not clearly defined. Our objective was to analyze the utility of dual-PET/CT (18F-FDG + 18F-Choline) imaging findings on the BCLC staging and treatment decision for HCC patients. METHODS Between January 2011 and April 2019, 168 consecutive HCC patients with available baseline dual-PET/CT imaging data were retrospectively analyzed. To identify potential refinement criteria for surgically-treated patients, survival Kaplan-Meier curves of various standard-of-care and dual-PET/CT baseline parameters were estimated. Finally, multivariate cox proportional hazard ratios of the most relevant clinico-biological and/or PET parameters were estimated. RESULTS Dual-PET/CT findings increased the score of BCLC staging in 21 (12.5%) cases. In 24.4% (N.=41) of patients, the treatment strategy was modified by the PET findings. Combining AFP levels at a threshold of 10 ng/mL with 18F-FDG or 18F-Choline N status significantly impacted DFS (P<0.05). In particular, the combined criteria of the N+ status assessed by 18F-Choline with AFP threshold of 10 ng/mL provided a highly predictive composite parameter for estimation of DFS according to multivariate analysis (HR=10.6, P<0.05). CONCLUSIONS The 18F-Choline / AFP composite parameter appears promising, and further prospective studies are mandatory to validate its oncological impact.
Collapse
Affiliation(s)
- Recep Erçin Sönmez
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France -
| | - Florent L Besson
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Paris-Saclay University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Paris-Saclay University, CEA, CNRS, Inserm, BioMaps, Orsay, France
- School of Medicine, Paris-Saclay Univrsity, Le Kremlin-Bicêtre, France
| | - Jerome Ghidaglia
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Paris-Saclay University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Maïté Lewin
- Department of Radiology, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Centre Hépato-Biliaire, Villejuif, France
| | - Lea Gomez
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Paris-Saclay University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Chady Salloum
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
| | - Gabriella Pittau
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
| | - Oriana Ciacio
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
| | - Marc Antoine Allard
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
- Department of Pathogenesis and Treatment of Liver Diseases, Paris-Saclay University, INSERM, UMR-S 1193, Paris, France
| | - Daniel Cherqui
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
- Department of Pathogenesis and Treatment of Liver Diseases, Paris-Saclay University, INSERM, UMR-S 1193, Paris, France
| | - René Adam
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
- Research Group Chronotherapy, Cancers and Transplantation, Paris-Saclay University, Paris, France
| | - Antonio Sa Cunha
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
- Department of Pathogenesis and Treatment of Liver Diseases, Paris-Saclay University, INSERM, UMR-S 1193, Paris, France
| | - Daniel Azoulay
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
| | - Eric Vibert
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
- Department of Pathogenesis and Treatment of Liver Diseases, Paris-Saclay University, INSERM, UMR-S 1193, Paris, France
| | - Nicolas Golse
- Department of Hepatobiliary Surgery, Hepato-Biliary Center, Paul-Brousse Hospital, Assistance Publique Hôpitaux de Paris, Villejuif, France
- Department of Pathogenesis and Treatment of Liver Diseases, Paris-Saclay University, INSERM, UMR-S 1193, Paris, France
| |
Collapse
|
10
|
Prakken NHJ, Besson FL, Borra RJH, Büther F, Buechel RR, Catana C, Chiti A, Dierckx RAJO, Dweck MR, Erba PA, Glaudemans AWJM, Gormsen LC, Hristova I, Koole M, Kwee TC, Mottaghy FM, Polycarpou I, Prokop M, Stegger L, Tsoumpas C, Slart RHJA. PET/MRI in practice: a clinical centre survey endorsed by the European Association of Nuclear Medicine (EANM) and the EANM Forschungs GmbH (EARL). Eur J Nucl Med Mol Imaging 2023; 50:2927-2934. [PMID: 37378857 DOI: 10.1007/s00259-023-06308-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Affiliation(s)
- Niek H J Prakken
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Florent L Besson
- Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), InsermBioMaps, Orsay, France
- Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Ronald J H Borra
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Florian Büther
- Department of Nuclear Medicine, University Hospital Münster, Munster, Germany
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and , Harvard Medical School, Boston, MA, USA
| | - Arturo Chiti
- Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Rudi A J O Dierckx
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK
| | - Paola A Erba
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Andor W J M Glaudemans
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lars C Gormsen
- Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus N, Denmark
| | - Ivalina Hristova
- European Association of Nuclear Medicine Research Ltd. (EARL), Vienna, Austria
| | - Michel Koole
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Thomas C Kwee
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Felix M Mottaghy
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, MUMC+), Maastricht, The Netherlands
| | - Irene Polycarpou
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Mathias Prokop
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lars Stegger
- Department of Nuclear Medicine, University Hospital Münster, Munster, Germany
| | - Charalampos Tsoumpas
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Riemer H J A Slart
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
| |
Collapse
|
11
|
Sivapathasundaram A, Golse N, Pascale A, Durand E, Sebagh M, Besson FL. Is 18 F-FDG/ 18 F-Choline Dual-Tracer PET Behavior a Surrogate of Tumor Differentiation in Hepatocellular Carcinoma : A Tertiary Center Dedicated Study. Clin Nucl Med 2023; 48:296-303. [PMID: 36728133 DOI: 10.1097/rlu.0000000000004574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND In hepatocellular carcinoma (HCC) setting, 18 F-FDG and 18 F-choline PET/CT radiotracers are classically considered surrogates of the degree of differentiation, a strong predictor of disease recurrence after curative treatment. Because the corresponding level of evidence has never been assessed as primary end point, the aim of this retrospective study was to specifically assess the relevance of 18 F-FDG combined to 18 F-choline PET imaging as a surrogate of tumor differentiation in HCC. PATIENTS AND METHODS A total of 49 histologically proven HCCs (46 patients treated by surgery or liver transplantation) with available baseline 18 F-FDG and 18 F-choline PET/CT, dedicated liver contrast-enhanced CT scan, and histological key features were retrospectively reviewed. Hepatocellular carcinoma tumors with well, moderately, and poorly differentiation (grades I, II, and III of the World Health Organization classification) were compared on their PET findings (double-blinded visual analysis and 8 usual semiquantitative metrics) by using nonparametric Kruskal-Wallis analyses of variance. In the case of statistical significance, pairwise post hoc tests with family-wise error rate adjustment were performed. RESULTS No statistical difference between the grades was observed for any of the patients' or lesions' characteristics ( P > 0.05), except for the macrovascular invasion between the grades I and II (adjusted P = 0.03). None of the PET findings showed statistical difference between the grades, except the tumor-to-background ratio of 18 F-FDG, higher for the grade III compared with grades I (adjusted P = 0.02) and II (adjusted P = 0.01). For less than one third of cases (14 lesions; 28.5%), the regional uptake was judged visually heterogeneous, but none of the related semiquantitative PET metrics were statistically discriminant ( P > 0.05). CONCLUSIONS Contrary to a common belief, 18 F-FDG/ 18 F-choline dual-tracer PET behavior is not a relevant surrogate of tumor differentiation in HCC. Future multitracer PET studies are mandatory to refine our knowledges of their deep biological meaning in this field.
Collapse
Affiliation(s)
- Abarnaa Sivapathasundaram
- From the Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | | | | | | | | |
Collapse
|
12
|
Iep A, Chawki MB, Goldfarb L, Nguyen L, Brulon V, Comtat C, Lebon V, Besson FL. Relevance of 18F-DOPA visual and semi-quantitative PET metrics for the diagnostic of Parkinson disease in clinical practice: a machine learning-based inference study. EJNMMI Res 2023; 13:13. [PMID: 36780091 PMCID: PMC9925664 DOI: 10.1186/s13550-023-00962-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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/02/2023] [Indexed: 02/14/2023] Open
Abstract
PURPOSE To decipher the relevance of visual and semi-quantitative 6-fluoro-(18F)-L-DOPA (18F-DOPA) interpretation methods for the diagnostic of idiopathic Parkinson disease (IPD) in hybrid positron emission tomography (PET) and magnetic resonance imaging. MATERIAL AND METHODS A total of 110 consecutive patients (48 IPD and 62 controls) with 11 months of median clinical follow-up (reference standard) were included. A composite visual assessment from five independent nuclear imaging readers, together with striatal standard uptake value (SUV) to occipital SUV ratio, striatal gradients and putamen asymmetry-based semi-quantitative PET metrics automatically extracted used to train machine learning models to classify IPD versus controls. Using a ratio of 70/30 for training and testing sets, respectively, five classification models-k-NN, LogRegression, support vector machine, random forest and gradient boosting-were trained by using 100 times repeated nested cross-validation procedures. From the best model on average, the contribution of PET parameters was deciphered using the Shapley additive explanations method (SHAP). Cross-validated receiver operating characteristic curves (cv-ROC) of the most contributive PET parameters were finally estimated and compared. RESULTS The best machine learning model (k-NN) provided final cv-ROC of 0.81. According to SHAP analyses, visual PET metric was the most important contributor to the model overall performance, followed by the minimum between left and right striatal to occipital SUV ratio. The 10-time cv-ROC curves of visual, min SUVr or both showed quite similar performance (mean area under the ROC of 0.81, 0.81 and 0.79, respectively, for visual, min SUVr or both). CONCLUSION Visual expert analysis remains the most relevant parameter to predict IPD diagnosis at 11 months of median clinical follow-up in 18F-FDOPA. The min SUV ratio appears interesting in the perspective of simple semi-automated diagnostic workflows.
Collapse
Affiliation(s)
- Alex Iep
- Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France.
| | - Mohammad B. Chawki
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Lucas Goldfarb
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Loc Nguyen
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Vincent Brulon
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Claude Comtat
- grid.460789.40000 0004 4910 6535 Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale BioMaps, SHFJ, Université Paris Saclay, Orsay, France
| | - Vincent Lebon
- grid.460789.40000 0004 4910 6535 Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale BioMaps, SHFJ, Université Paris Saclay, Orsay, France
| | - Florent L. Besson
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| |
Collapse
|
13
|
Ghidaglia J, Laurent V, Sebagh M, Pascale A, Durand E, Golse N, Besson FL. Influence of key histological characteristics on 18F-fluorodeoxyglucose /18F-choline positron emission tomography positivity in hepatocellular carcinoma: A machine learning study. Front Med (Lausanne) 2023; 10:1087957. [PMID: 36744142 PMCID: PMC9892182 DOI: 10.3389/fmed.2023.1087957] [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: 11/02/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023] Open
Abstract
Purpose To determine the characteristics influence of key histological on 18F-fluorodeoxyglucose (18F-FDG) and 18F-choline positron emission tomography (PET) positivity in hepatocellular carcinoma (HCC). Materials and methods The 18F-FDG/18F-choline PET imaging findings of 103 histologically proven HCCs (from 62 patients, of which 47 underwent hepatectomy and 15 received liver transplantation) were retrospectively examined to assess the following key histological parameters: Grade, capsule, microvascular invasion (mVI), macrovascular invasion (MVI), and necrosis. Using a ratio of 70/30 for training and testing sets, respectively, a penalized classification model (Elastic Net) was trained using 100 repeated cross-validation procedures (10-fold cross-validation for hyperparameter optimization). The contribution of each histological parameter to the PET positivity was determined using the Shapley Additive Explanations method. Receiver operating characteristic curves with and without dimensionality reduction were finally estimated and compared. Results Among the five key histological characteristics of HCC (Grade, capsule, mVI, MVI, and necrosis), mVI and tumor Grade (I-III) showed the highest relevance and robustness in explaining HCC uptake of 18F-FDG and 18F-choline. MVI and necrosis status both showed high instability in outcome predictions. Tumor capsule had a minimal influence on the model predictions. On retaining only mVI and Grades I-III for the final analysis, the area under the receiver operating characteristic (ROC) curve values were maintained (0.68 vs. 0.63, 0.65 vs. 0.64, and 0.65 vs. 0.64 for 18F-FDG, 18F-choline, and their combination, respectively). Conclusion 18F-FDG/18F-choline PET positivity appears driven by both the Grade and mVI components in HCC. Consideration of the tumor microenvironment will likely be necessary to improve our understanding of multitracer PET positivity.
Collapse
Affiliation(s)
- Jérôme Ghidaglia
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Vincent Laurent
- Université Paris-Saclay, Centre Borelli, Gif-sur-Yvette, France
| | - Mylène Sebagh
- Department of Pathology, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France,Universite Paris-Saclay, Inserm, Physiopathogènése et Traitement des Maladies du Foie, UMR-S 1193, Villejuif, Île-de-France, France,Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France
| | - Alina Pascale
- Universite Paris-Saclay, Inserm, Physiopathogènése et Traitement des Maladies du Foie, UMR-S 1193, Villejuif, Île-de-France, France,Centre Hépato Biliaire, Hepatobiliary and Liver Transplant Unit, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Villejuif, France
| | - Emmanuel Durand
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France,Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France,Université Paris-Saclay, Commissariat à l’énergie atomique et aux énergies alternatives (CEA), Centre National de la Recherche Scientifique (CNRS), Inserm, BioMaps, Le Kremlin-Bicêtre, France
| | - Nicolas Golse
- Universite Paris-Saclay, Inserm, Physiopathogènése et Traitement des Maladies du Foie, UMR-S 1193, Villejuif, Île-de-France, France,Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France,Centre Hépato Biliaire, Hepatobiliary and Liver Transplant Unit, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Villejuif, France
| | - Florent L. Besson
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France,Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France,Université Paris-Saclay, Commissariat à l’énergie atomique et aux énergies alternatives (CEA), Centre National de la Recherche Scientifique (CNRS), Inserm, BioMaps, Le Kremlin-Bicêtre, France,*Correspondence: Florent L. Besson,
| |
Collapse
|
14
|
Sardana M, Breuil L, Goutal S, Goislard M, Kondrashov M, Marchal E, Besson FL, Dugave C, Wrigley G, Jonson AC, Kuhnast B, Schou M, Tournier N, Elmore CS, Caillé F. Isotopic Radiolabeling of Crizotinib with Fluorine-18 for In Vivo Pet Imaging. Pharmaceuticals (Basel) 2022; 15:1568. [PMID: 36559018 PMCID: PMC9782192 DOI: 10.3390/ph15121568] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Crizotinib is a tyrosine kinase inhibitor approved for the treatment of non-small-cell lung cancer, but it is inefficient on brain metastases. Crizotinib is a substrate of the P-glycoprotein, and non-invasive nuclear imaging can be used to assess the brain penetration of crizotinib. Positron emission tomography (PET) imaging using fluorine-18-labeled crizotinib would be a powerful tool for investigating new strategies to enhance the brain distribution of crizotinib. We have synthesized a spirocyclic hypervalent iodine precursor for the isotopic labeling of crizotinib in a 2.4% yield. Because crizotinib is an enantiomerically pure drug, a chiral separation was performed to afford the (R)-precursor. A two-step radiolabeling process was optimized and automated using the racemic precursor to afford [18F](R,S)-crizotinib in 15 ± 2 radiochemical yield and 103 ± 18 GBq/µmol molar activity. The same radiolabeling process was applied to the (R)-precursor to afford [18F](R)-crizotinib with comparable results. As a proof-of-concept, PET was realized in a single non-human primate to demonstrate the feasibility of [18F](R)-crizotinib in in vivo imaging. Whole-body PET highlighted the elimination routes of crizotinib with negligible penetration in the brain (SUVmean = 0.1). This proof-of-concept paves the way for further studies using [18F](R)-crizotinib to enhance its brain penetration depending on the P-glycoprotein function.
Collapse
Affiliation(s)
- Malvika Sardana
- Early Chemical Development, Pharmaceutical Sciences, Bio Pharmaceuticals R&D, AstraZeneca, 43150 Gothenburg, Sweden
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Louise Breuil
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Sébastien Goutal
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Maud Goislard
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Mikhail Kondrashov
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
| | - Etienne Marchal
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Florent L. Besson
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Christophe Dugave
- Université Paris-Saclay, Service de Chimie Bio-organique et Marquage (SCBM), CEA/DRF/JOLIOT, 91191 Gif-sur-Yvette, France
| | - Gail Wrigley
- Medicinal Chemistry, Oncology R&D, AstraZeneca, Cambridge CB2 0AA, UK
| | - Anna C. Jonson
- Early Chemical Development, Pharmaceutical Sciences, Bio Pharmaceuticals R&D, AstraZeneca, 43150 Gothenburg, Sweden
| | - Bertrand Kuhnast
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Magnus Schou
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, SE-171 76 Stockholm, Sweden
- AZ PET Science Centre at Karolinska Institutet, Oncology R&D, AstraZeneca, 15185 Stockholm, Sweden
| | - Nicolas Tournier
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| | - Charles S. Elmore
- Early Chemical Development, Pharmaceutical Sciences, Bio Pharmaceuticals R&D, AstraZeneca, 43150 Gothenburg, Sweden
| | - Fabien Caillé
- Université Paris-Saclay, Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale Paris-Saclay (BioMaps), 91401 Orsay, France
| |
Collapse
|
15
|
Pean De Ponfilly – Sotier M, Seror R, Nocturne G, Besson FL. 18F-FDG PET molecular imaging: A relevant tool to investigate chronic inflammatory rheumatisms in clinical practice? Front Med (Lausanne) 2022; 9:1070445. [PMID: 36530882 PMCID: PMC9748427 DOI: 10.3389/fmed.2022.1070445] [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: 10/14/2022] [Accepted: 11/15/2022] [Indexed: 12/31/2023] Open
Abstract
18F-Labeled Fluorodeoxyglucose-Positron Emission Tomography (18F-FDG PET) is a molecular imaging tool commonly used in practice for the assessment of many cancers. Thanks to its properties, its use has been progressively extended to numerous inflammatory conditions, including chronic inflammatory rheumatism (CIR) such as rheumatoid arthritis (RA), spondylarthritis (SpAs) and polymyalgia rheumatica (PMR). 18F-FDG PET is currently not recommended for the diagnostic of CIRs. However, this whole-body imaging tool has emerged in clinical practice, providing a general overview of systemic involvement occurring in CIRs. Numerous studies have highlighted the capacity of 18F-FDG PET to detect articular and extra articular involvements in RA and PMR. However, the lack of specificity of 18F-FDG limits its use for diagnosis purpose. Finally, the key question is the definition of the best way to integrate this whole-body imaging tool in the patient's management workflow.
Collapse
Affiliation(s)
| | - Raphaële Seror
- Rheumatology, AP-HP. Université Paris-Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, INSERM, CEA, Centre de Recherche en Immunologie des Infections Virales et des Maladies Auto-immunes, Le Kremlin-Bicêtre, France
| | - Gaetane Nocturne
- Rheumatology, AP-HP. Université Paris-Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, INSERM, CEA, Centre de Recherche en Immunologie des Infections Virales et des Maladies Auto-immunes, Le Kremlin-Bicêtre, France
| | - Florent L. Besson
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Biophysics and Nuclear Medicine-Molecular Imaging, AP-HP. Université Paris-Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| |
Collapse
|
16
|
Ghidaglia J, Golse N, Pascale A, Sebagh M, Besson FL. 18F-FDG /18F-Choline Dual-Tracer PET Behavior and Tumor Differentiation in HepatoCellular Carcinoma. A Systematic Review. Front Med (Lausanne) 2022; 9:924824. [PMID: 35872754 PMCID: PMC9300997 DOI: 10.3389/fmed.2022.924824] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 04/20/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background Post-operative recurrence remains the strongest prognostic factor of resected hepatocellular carcinoma (HCC), making the accurate selection of patients with curable HCC a crucial issue. PET imaging combining both 18F-FDG and fatty acid synthase (FAS) radiotracers—such as Choline—has shown its interest for the initial staging and therapeutic management of patients with HCC, but its use is still not consensual. Importantly, the very first dual-tracer PET studies suggested 18F-FDG/FAS PET behavior be linked to the degree of differentiation of HCC, a major predictive factor of post-operative recurrence. Although this key molecular imaging concept may impact how dual-tracer PET will be used in early-stage HCC, its level of evidence remains largely unexplored. In this study, we conducted a systematic review of the available evidence-based data to clarify the relevance of dual 18F-FDG/18F-Choline PET in characterizing the degree of differentiation of HCC tumors. Methods A systematic search of the PubMed/Medline and Embase databases was performed up to November 2021. A systematic review of the dual-tracer 18F-FDG/18F-Choline PET behavior of histology-proven HCC according to their degree of differentiation was conducted. The overall quality of the included studies was critically assessed based on the STROBE guidelines. Information on study date, design, patient cohort characteristics, grade of differentiation of HCC tumors, and the dual-tracer PET behavior per HCC was independently extracted and summarized. Results From 440 records initially available, 6 full-text articles (99 histology-proven HCC) provided dual-tracer 18F-FDG/18F-Choline PET behavior per HCC tumor grade were included in the systematic review. Based on our analysis, 43/99 HCCs were reported to be well-differentiated, and 56/99 HCCs were reported to be less-differentiated tumors. In the well-differentiated subgroup, more than half were exclusively positive for 18F-Choline (51%), whereas 39% were positive for both 18F-FDG and 18F-Choline. In the less-differentiated subgroup, 37% of HCC patients were positive exclusively for FDG, 36% were positive for both 18F-FDG and 18F-Choline, and 25% were positive exclusively for 18F-Choline. Conclusion The 18F-FDG/18F-Choline dual-tracer PET behavior of uptake shows high overlap between well- and less differentiated HCC, making the characterization of tumors challenging based on such PET combination alone. Given our growing knowledge of the molecular complexity of HCC, further studies are necessary to refine our understanding of radiotracers’ behavior in this field and improve the usefulness of PET imaging in the clinical decision process of HCC.
Collapse
Affiliation(s)
- Jérôme Ghidaglia
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Nicolas Golse
- Centre Hépato Biliaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Villejuif, France.,Université Paris-Saclay, INSERM, Physiopathogénèse et Traitement des Maladies du Foie, UMR-S 1193, Gif-sur-Yvette, France
| | - Alina Pascale
- Centre Hépato Biliaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Villejuif, France
| | - Mylène Sebagh
- Department of Pathology, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Florent L Besson
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| |
Collapse
|
17
|
Shaw A, Seban RD, Besson FL, Vila-Reyes H, Ammari S, Mokrane FZ, Yeh R, Dercle L. Editorial: Breakthrough in Imaging-Guided Precision Medicine in Oncology. Front Oncol 2022; 12:908561. [PMID: 35664770 PMCID: PMC9159369 DOI: 10.3389/fonc.2022.908561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ashley Shaw
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY, United States
| | - Romain-David Seban
- Department of Nuclear Medicine, Institut Curie, Paris, France.,Laboratory of Translational Imaging in Oncology, Paris Sciences et Lettres University (PSL) Research University, Institut Curie, Orsay, France
| | - Florent L Besson
- Department of Nuclear Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Helena Vila-Reyes
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY, United States
| | - Samy Ammari
- Department of Medical Imaging, Institut Gustave Roussy, Villejuif, France
| | - Fatima-Zohra Mokrane
- Department of Radiology, Faculté de Médecine Rangueil, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Randy Yeh
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Laurent Dercle
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY, United States
| |
Collapse
|
18
|
Nocturne G, Besson FL, Ponfilly-Sotier MPD, Seror R. Answer to Giraud et al. "On the use of 18F FDG PET-CT in spondyloarthritis." Joint Bone Spine 2022. 89:105377 and to Falsetti et al. "Polymyalgia Rheumatica: a syndrome with an enthesitic subset?" Joint Bone Spine 2022; 89: 105378. Joint Bone Spine 2022; 89:105379. [PMID: 35331915 DOI: 10.1016/j.jbspin.2022.105379] [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: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Gaetane Nocturne
- Université Paris-Saclay, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Inserm UMR 1184, France.
| | - Florent L Besson
- Biophysics and Nuclear Medicine-Molecular Imaging, AP-HP. Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France and Université Paris-Saclay/CEA/CNRS/Inserm, BioMaps, Orsay, France
| | | | - Raphaele Seror
- Université Paris-Saclay, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Inserm UMR 1184, France
| |
Collapse
|
19
|
Parreau S, Nocturne G, Mariette X, Burroni B, Lazure T, Besson FL, Régent A, Mouthon L, Terrier B, Seror R, Le Guern V. Features of non-Hodgkin’s lymphoma diagnosed in minor salivary gland biopsies from primary Sjögren’s syndrome patients. Rheumatology (Oxford) 2021; 61:3818-3823. [DOI: 10.1093/rheumatology/keab949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
To evaluate the contribution of minor salivary gland biopsy (mSGB) histology to diagnosing primary Sjögren’s syndrome (pSS)-associated non-Hodgkin B cell lymphoma (NHL).
Methods
pSS patients with mSGB at NHL diagnosis were included.
Results
Among the 24 patients (92.3% female; mean age: 61.3 years) with an mSGB at NHL diagnosis, 13 (54.2%) had mSGB-histology–revealed NHL (mSGB+); it was the only site enabling NHL diagnosis in 10/13 (76.9%) patients. Mucosa-associated lymphoid tissue (MALT) lymphoma was found in 23/24 (95.8%) patients; 100% of mSGB+ identified MALT lymphomas. pSS and lymphoma characteristics were comparable for mSGB+ and mSGB– patients. Eight (61.5%) of the 13 mSGB+ patients and all 11 mSGB– patients were treated for lymphoma. Between diagnosis and 1 year of follow-up, ESSDAI without the NHL item remained stable (7.4 vs 5.0; p = 0.33) for the five untreated patients, while it decreased significantly for the 19 treated patients (15.8 vs 5.1; p = 0.004).
Conclusion
For pSS patients with suspected NHL, mSGB histology enabled NHL diagnosis in half of them, MALT was found in 95.8% and all mSGBs+ were MALT lymphomas, thereby avoiding more invasive biopsy. Our results suggest that mSGB should be obtained at pSS diagnosis and repeated during follow-up, when NHL is suspected.
Collapse
Affiliation(s)
- Simon Parreau
- Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Paris
| | - Gaétane Nocturne
- Department of Rheumatology, Université Paris-Saclay, FHU CARE (Cancer and Autoimmunity RElationship), INSERM UMR1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre
| | - Xavier Mariette
- Department of Rheumatology, Université Paris-Saclay, FHU CARE (Cancer and Autoimmunity RElationship), INSERM UMR1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre
| | - Barbara Burroni
- Department of Pathology, Université Paris Descartes, Hôpital Cochin, APHP, Paris
| | - Thierry Lazure
- Department of Pathology, Université Paris-Saclay, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre
| | - Florent L Besson
- Department of Biophysics, Nuclear Medicine-Molecular Imaging, Université Paris-Saclay, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, France, Orsay
| | - Alexis Régent
- Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Paris
| | - Luc Mouthon
- Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Paris
| | - Benjamin Terrier
- Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Paris
| | - Raphaele Seror
- Department of Rheumatology, Université Paris-Saclay, FHU CARE (Cancer and Autoimmunity RElationship), INSERM UMR1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre
| | - Véronique Le Guern
- Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris (APHP), Paris
| |
Collapse
|
20
|
Pean de Ponfilly-Sotier M, Besson FL, Gomez L, Ottaviani S, Dieudé P, Pavy S, Mariette X, Seror R, Nocturne G. Use of 18F FDG PET-CT to discriminate polymyalgia rheumatica and atypical spondylarthritis in clinical practice. Joint Bone Spine 2021; 89:105325. [PMID: 34915108 DOI: 10.1016/j.jbspin.2021.105325] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the relevance of 18F-labeled fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET-CT) for discriminating polymyalgia rheumatica (PMR) and spondylarthritis (SpA) in atypical presentations. METHODS In 2 rheumatology departments, we identified PMR and atypical SpA patients who underwent 18F-FDG PET-CT and compared the 2 groups. The relevant 18F-FDG PET-CT findings identified on univariate analyses as discriminant for both groups were entered into a multivariable logistic regression model to derive a composite musculoskeletal score. RESULTS Between September 2012 and August 2018, we enrolled 35 PMR and 27 SpA patients (median [interquartile range] age 71 years [63.5-74.5] and 54 years [41.5-63], p < 0.001). 18F-FDG uptake in enthesis/bursae was more frequent in PMR than SpA (ischial tuberosities: 88.6% vs 48.1%, p < 0.001; interspinous processes: 91.4% vs 51.9%, p < 0.001). 18F-FDG uptake in sacroiliac joints was specific to SpA but rare (14.8% vs 0 in PMR, p < 0.05). The intensity of 18F-FDG uptake was similar in both conditions. The musculoskeletal score, including 18F-FDG uptake of the shoulders, ischial tuberosities and interspinous process, was higher for PMR than SpA patients (2.74 vs 1.11, p < 0.001). A score ≥ 2 provided sensitivity and specificity of 74.1% and 77.1% for the diagnosis of PMR. CONCLUSION 18F-FDG PET-CT patterns of atypical SpA and PMR widely overlap, so differentiating the conditions is challenging. The use of the proposed PET-CT composite score could improve the diagnostic performance of 18F-FDG PET-CT to discriminate these 2 entities in clinical practice.
Collapse
Affiliation(s)
| | - Florent L Besson
- Biophysics and Nuclear Medicine-Molecular Imaging, AP-HP. Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Université Paris-Saclay/CEA/CNRS/Inserm, BioMaps, Orsay, France
| | - Léa Gomez
- Biophysics and Nuclear Medicine-Molecular Imaging, AP-HP. Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | | | - Philippe Dieudé
- Rheumatology, APHP, Université Paris Diderot, Hôpital Bichat, Paris, France
| | - Stephane Pavy
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Xavier Mariette
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Raphaele Seror
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Gaetane Nocturne
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Université Paris-Saclay, INSERM, CEA, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes, Le Kremlin-Bicêtre, France.
| |
Collapse
|
21
|
Besson FL, Fernandez B, Faure S, Mercier O, Seferian A, Mussot S, Levy A, Parent F, Bulifon S, Jais X, Montani D, Mitilian D, Fadel E, Planchard D, Ghigna-Bellinzoni MR, Comtat C, Lebon V, Durand E. Fully Integrated Quantitative Multiparametric Analysis of Non-Small Cell Lung Cancer at 3-T PET/MRI: Toward One-Stop-Shop Tumor Biological Characterization at the Supervoxel Level. Clin Nucl Med 2021; 46:e440-e447. [PMID: 34374682 DOI: 10.1097/rlu.0000000000003680] [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: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to study the feasibility of a fully integrated multiparametric imaging framework to characterize non-small cell lung cancer (NSCLC) at 3-T PET/MRI. PATIENTS AND METHODS An 18F-FDG PET/MRI multiparametric imaging framework was developed and prospectively applied to 11 biopsy-proven NSCLC patients. For each tumor, 12 parametric maps were generated, including PET full kinetic modeling, apparent diffusion coefficient, T1/T2 relaxation times, and DCE full kinetic modeling. Gaussian mixture model-based clustering was applied at the whole data set level to define supervoxels of similar multidimensional PET/MRI behaviors. Taking the multidimensional voxel behaviors as input and the supervoxel class as output, machine learning procedure was finally trained and validated voxelwise to reveal the dominant PET/MRI characteristics of these supervoxels at the whole data set and individual tumor levels. RESULTS The Gaussian mixture model-based clustering clustering applied at the whole data set level (17,316 voxels) found 3 main multidimensional behaviors underpinned by the 12 PET/MRI quantitative parameters. Four dominant PET/MRI parameters of clinical relevance (PET: k2, k3 and DCE: ve, vp) predicted the overall supervoxel behavior with 97% of accuracy (SD, 0.7; 10-fold cross-validation). At the individual tumor level, these dimensionality-reduced supervoxel maps showed mean discrepancy of 16.7% compared with the original ones. CONCLUSIONS One-stop-shop PET/MRI multiparametric quantitative analysis of NSCLC is clinically feasible. Both PET and MRI parameters are useful to characterize the behavior of tumors at the supervoxel level. In the era of precision medicine, the full capabilities of PET/MRI would give further insight of the characterization of NSCLC behavior, opening new avenues toward image-based personalized medicine in this field.
Collapse
Affiliation(s)
| | | | - Sylvain Faure
- Laboratoire de Mathématiques d'Orsay, CNRS, Université Paris-Saclay, Orsay
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | | | - Sacha Mussot
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | | | | | | | | | | | - Delphine Mitilian
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | - Elie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital
| | - David Planchard
- Oncology, Institut d'Oncologie Thoracique, Gustave Roussy, Université Paris Saclay, Villejuif
| | | | | | | | | |
Collapse
|
22
|
Carvès S, Bourgeon-Ghittori M, Henry J, Belkhir R, Besson FL, Levante S, Mariette X, Seror R. Denosumab in active Charcot neuro-osteoarthropathy of the foot. Joint Bone Spine 2021; 88:105241. [PMID: 34146697 DOI: 10.1016/j.jbspin.2021.105241] [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: 03/20/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Active Charcot Neuro-osteoarthropathy (CN) is a rare and severe complication of peripheral neuropathy that leads to deformity and disability. No pharmacological treatment is available. Increased osteoclastic activity plays a central role in active CN, particularly via receptor activator of nuclear factor ligand (RANK-L). We aimed to describe clinical, morphological and metabolic imaging effects of denosumab, a fully human monoclonal anti- RANK-L antibody, in active CN. METHODS In this open-label study, we included all consecutive patients with active refractory CN treated with denosumab in our tertiary center. Baseline and follow-up assessment included clinical examination, biological and imaging procedures (morphological and metabolic) before and after treatment. RESULTS Seven patients were treated with denosumab between 2017 and 2020 and followed for a median of 16 months [6-39]. All patients clinically improved, 4 further relapsed after a median of 4 months [3-33]. Four patients were retreated with the same efficacy. Imaging follow-up available in 5 patients showed stability of structural damage (radiography) and a significant decrease of metabolic activity (FDG PET-CT) in 4 of them. No adverse event or hypocalcemia was observed. CONCLUSION In patients with refractory active CN, denosumab had a clinical effect, prevented bone and joint destruction, together with a metabolic effect, as assessed by FDG PET-CT. These results justify the conduction of a randomized controlled trial to assess the efficacy of denosumab in acute CN.
Collapse
Affiliation(s)
- Sandrine Carvès
- Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay (UPS), service de rhumatologie, hôpital Bicêtre, INSERM UMR 1184, Le Kremlin-Bicêtre, France
| | - Muriel Bourgeon-Ghittori
- AP-HP, UPS, service d'endocrinologie, hôpital Antoine-Béclère, Clamart,et Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Julien Henry
- Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay (UPS), service de rhumatologie, hôpital Bicêtre, INSERM UMR 1184, Le Kremlin-Bicêtre, France
| | - Rakiba Belkhir
- Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay (UPS), service de rhumatologie, hôpital Bicêtre, INSERM UMR 1184, Le Kremlin-Bicêtre, France
| | - Florent L Besson
- AP-HP, UPS, service de Biophysique et Médecine nuclaire, hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Stéphane Levante
- AP-HP, UPS, Service d'orthopédie, hôpital Antoine-Béclère, Clamart, France
| | - Xavier Mariette
- Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay (UPS), service de rhumatologie, hôpital Bicêtre, INSERM UMR 1184, Le Kremlin-Bicêtre, France
| | - Raphaèle Seror
- Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay (UPS), service de rhumatologie, hôpital Bicêtre, INSERM UMR 1184, Le Kremlin-Bicêtre, France.
| |
Collapse
|
23
|
Duclos V, Iep A, Gomez L, Goldfarb L, Besson FL. PET Molecular Imaging: A Holistic Review of Current Practice and Emerging Perspectives for Diagnosis, Therapeutic Evaluation and Prognosis in Clinical Oncology. Int J Mol Sci 2021; 22:4159. [PMID: 33923839 PMCID: PMC8073681 DOI: 10.3390/ijms22084159] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 04/03/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 02/06/2023] Open
Abstract
PET/CT molecular imaging has been imposed in clinical oncological practice over the past 20 years, driven by its two well-grounded foundations: quantification and radiolabeled molecular probe vectorization. From basic visual interpretation to more sophisticated full kinetic modeling, PET technology provides a unique opportunity to characterize various biological processes with different levels of analysis. In clinical practice, many efforts have been made during the last two decades to standardize image analyses at the international level, but advanced metrics are still under use in practice. In parallel, the integration of PET imaging with radionuclide therapy, also known as radiolabeled theranostics, has paved the way towards highly sensitive radionuclide-based precision medicine, with major breakthroughs emerging in neuroendocrine tumors and prostate cancer. PET imaging of tumor immunity and beyond is also emerging, emphasizing the unique capabilities of PET molecular imaging to constantly adapt to emerging oncological challenges. However, these new horizons face the growing complexity of multidimensional data. In the era of precision medicine, statistical and computer sciences are currently revolutionizing image-based decision making, paving the way for more holistic cancer molecular imaging analyses at the whole-body level.
Collapse
Affiliation(s)
- Valentin Duclos
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
| | - Alex Iep
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
| | - Léa Gomez
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
| | - Lucas Goldfarb
- Service Hospitalier Frédéric Joliot-CEA, 91401 Orsay, France;
| | - Florent L. Besson
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
- Université Paris Saclay, CEA, CNRS, Inserm, BioMaps, 91401 Orsay, France
- School of Medicine, Université Paris Saclay, 94720 Le Kremlin-Bicêtre, France
| |
Collapse
|
24
|
Barlet J, Virone A, Gomez L, Adam C, Mariette X, Durand E, Besson FL. 18F-FDG PET/CT and MRI findings of Shulman syndrome also known as eosinophilic fasciitis. Eur J Nucl Med Mol Imaging 2021; 48:2049-2050. [PMID: 33462629 DOI: 10.1007/s00259-020-05172-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/20/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Juliette Barlet
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Alexandre Virone
- Department of Rheumatology, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Léa Gomez
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Clovis Adam
- Department of Pathology, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Emmanuel Durand
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Florent L Besson
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
| |
Collapse
|
25
|
Boucneau T, Fernandez B, Besson FL, Menini A, Wiesinger F, Durand E, Caramella C, Darrasse L, Maître X. AZTEK: Adaptive zero TE k-space trajectories. Magn Reson Med 2020; 85:926-935. [PMID: 32936490 DOI: 10.1002/mrm.28483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/22/2020] [Accepted: 07/27/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Because of short signal lifetimes and respiratory motion, 3D lung MRI is still challenging today. Zero-TE (ZTE) pulse sequences offer promising solutions as they overcome the issue of short T 2 ∗ . Nevertheless, as they rely on continuous readout gradients, the trajectories they follow in k-space are not adapted to retrospective gating and inferred motion correction. THEORY AND METHODS We propose AZTEK (adaptive ZTE k-space trajectories), a set of 3D radial trajectories featuring three tuning parameters, to adapt the acquisition to any moving organ while keeping seamless transitions between consecutive spokes. Standard ZTE and AZTEK trajectories were compared for static and moving phantom acquisitions as well as for human thoracic imaging performed on 3 volunteers (1 healthy and 2 patients with lung cancer). RESULTS For the static phantom, we observe comparable image qualities with standard and AZTEK trajectories. For the moving phantom, spatially coherent undersampling artifacts observed on gated images with the standard trajectory are alleviated with AZTEK. The same improvement in image quality is obtained in human, so details are more delineated in the lung with the use of the adaptive trajectory. CONCLUSION The AZTEK technique opens the possibility for 3D dynamic ZTE lung imaging with retrospective gating. It enables us to uniformly sample the k-space for any arbitrary respiratory motion gate, while preserving static image quality, improving dynamic image quality and guaranteeing continuous readout gradient transitions between spokes, which makes it appropriate to ZTE.
Collapse
Affiliation(s)
- Tanguy Boucneau
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | | | - Florent L Besson
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France.,Université Paris-Saclay, Department of Biophysics and Nuclear Medicine, Hopitaux Universitaires Paris-Saclay, Le Kremlin Bicêtre, France
| | - Anne Menini
- Applications & Workflow, GE Healthcare, Menlo Park, California, USA
| | | | - Emmanuel Durand
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France.,Université Paris-Saclay, Department of Biophysics and Nuclear Medicine, Hopitaux Universitaires Paris-Saclay, Le Kremlin Bicêtre, France
| | | | - Luc Darrasse
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Xavier Maître
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| |
Collapse
|
26
|
Besson FL, Fernandez B, Faure S, Mercier O, Seferian A, Mignard X, Mussot S, le Pechoux C, Caramella C, Botticella A, Levy A, Parent F, Bulifon S, Montani D, Mitilian D, Fadel E, Planchard D, Besse B, Ghigna-Bellinzoni MR, Comtat C, Lebon V, Durand E. 18F-FDG PET and DCE kinetic modeling and their correlations in primary NSCLC: first voxel-wise correlative analysis of human simultaneous [18F]FDG PET-MRI data. EJNMMI Res 2020; 10:88. [PMID: 32734484 PMCID: PMC7392998 DOI: 10.1186/s13550-020-00671-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To decipher the correlations between PET and DCE kinetic parameters in non-small-cell lung cancer (NSCLC), by using voxel-wise analysis of dynamic simultaneous [18F]FDG PET-MRI. MATERIAL AND METHODS Fourteen treatment-naïve patients with biopsy-proven NSCLC prospectively underwent a 1-h dynamic [18F]FDG thoracic PET-MRI scan including DCE. The PET and DCE data were normalized to their corresponding T1-weighted MR morphological space, and tumors were masked semi-automatically. Voxel-wise parametric maps of PET and DCE kinetic parameters were computed by fitting the dynamic PET and DCE tumor data to the Sokoloff and Extended Tofts models respectively, by using in-house developed procedures. Curve-fitting errors were assessed by computing the relative root mean square error (rRMSE) of the estimated PET and DCE signals at the voxel level. For each tumor, Spearman correlation coefficients (rs) between all the pairs of PET and DCE kinetic parameters were estimated on a voxel-wise basis, along with their respective bootstrapped 95% confidence intervals (n = 1000 iterations). RESULTS Curve-fitting metrics provided fit errors under 20% for almost 90% of the PET voxels (median rRMSE = 10.3, interquartile ranges IQR = 8.1; 14.3), whereas 73.3% of the DCE voxels showed fit errors under 45% (median rRMSE = 31.8%, IQR = 22.4; 46.6). The PET-PET, DCE-DCE, and PET-DCE voxel-wise correlations varied according to individual tumor behaviors. Beyond this wide variability, the PET-PET and DCE-DCE correlations were mainly high (absolute rs values > 0.7), whereas the PET-DCE correlations were mainly low to moderate (absolute rs values < 0.7). Half the tumors showed a hypometabolism with low perfused/vascularized profile, a hallmark of hypoxia, and tumor aggressiveness. CONCLUSION A dynamic "one-stop shop" procedure applied to NSCLC is technically feasible in clinical practice. PET and DCE kinetic parameters assessed simultaneously are not highly correlated in NSCLC, and these correlations showed a wide variability among tumors and patients. These results tend to suggest that PET and DCE kinetic parameters might provide complementary information. In the future, this might make PET-MRI a unique tool to characterize the individual tumor biological behavior in NSCLC.
Collapse
Affiliation(s)
- Florent L Besson
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France.
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France.
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
| | | | - Sylvain Faure
- Laboratoire de Mathématiques d'Orsay, CNRS, Université Paris-Saclay, 91405, Orsay, France
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Andrei Seferian
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Xavier Mignard
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
| | - Sacha Mussot
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Cecile le Pechoux
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Caroline Caramella
- Department of Radiology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Angela Botticella
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Antonin Levy
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Florence Parent
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Sophie Bulifon
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - David Montani
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Delphine Mitilian
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Elie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - David Planchard
- Department of Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Benjamin Besse
- Department of Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | | | - Claude Comtat
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Vincent Lebon
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Emmanuel Durand
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| |
Collapse
|
27
|
Besson FL, Fernandez B, Faure S, Mercier O, Seferian A, Blanchet É, Mignard X, Chetouani A, Bulifon S, Mussot S, Parent F, Bouderraoui F, Montani D, Mitilian D, Fadel E, Ghigna-Bellinzoni MR, Cherkaoui H, Comtat C, Lebon V, Durand E. Diffusion-weighted Imaging Voxelwise-matched Analyses of Lung Cancer at 3.0-T PET/MRI: Reverse Phase Encoding Approach for Echo-planar Imaging Distortion Correction. Radiology 2020; 295:692-700. [PMID: 32208099 DOI: 10.1148/radiol.2020192013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background PET/MRI has drawn increasing interest in thoracic oncology due to the simultaneous acquisition of PET and MRI data. Geometric distortions related to diffusion-weighted imaging (DWI) limit the evaluation of voxelwise multimodal analyses. Purpose To assess the effectiveness of reverse phase encoding in correcting DWI geometric distortion for multimodal PET/MRI voxelwise lung tumor analyses. Materials and Methods In this prospective study, reverse phase encoding method was implemented with 3.0-T PET/MRI to correct geometric distortions related to DWI. The method was validated in dedicated phantom and then applied to 12 consecutive patients (mean age, 66 years ± 13 [standard deviation]; 10 men) suspected of having lung cancer who underwent fluorodeoxyglucose PET/MRI between October 2018 and April 2019. The effects on DWI-related image matching and apparent diffusion coefficient (ADC) regional map computation were assessed. Consequences on multimodal PET/MRI voxelwise lung tumor analyses were evaluated. Spearman correlation coefficients (rs) between the standardized uptake value (SUV) and ADC data corrected for distortion were computed from optimal realigned DWI PET data, along with bootstrap confidence intervals. Results Phantom results showed that in highly distorted areas, correcting the distortion significantly reduced the mean error against the ground truth (-25% ± 10.6 to -18.4% ± 12.6; P < .001) and the number of voxels with more than 20% error (from 85.3% to 31.4%). In the 12 patients, the coregistration of multimodal PET/MRI tumor data was improved by using the reverse phase encoding method (0.4%-44%). In all tumors, voxelwise correlations (rs) between ADC and SUV revealed null or weak monotonic relationships (mean rs of 0.016 ± 0.24 with none above 0.5). Conclusion Reverse phase encoding is a simple-to-implement method for improved diffusion-weighted multimodal PET/MRI voxelwise-matched analyses in lung cancer. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Colletti in this issue.
Collapse
Affiliation(s)
- Florent L Besson
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Brice Fernandez
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Sylvain Faure
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Olaf Mercier
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Andrei Seferian
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Élise Blanchet
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Xavier Mignard
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Ahmed Chetouani
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Sophie Bulifon
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Sacha Mussot
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Florence Parent
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Fahd Bouderraoui
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - David Montani
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Delphine Mitilian
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Elie Fadel
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Maria-Rosa Ghigna-Bellinzoni
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Hamza Cherkaoui
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Claude Comtat
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Vincent Lebon
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| | - Emmanuel Durand
- From the Dept of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (F.L.B., E.D.); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France (F.L.B., O.M., A.S., S.B., S.M., F.P., D. Montani, D. Mitiliian, E.F., V.L., E.D.), Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France (F.L.B., C.C., V.L., E.D.); Applications and Workflow, GE Healthcare, Buc, France (B.F.); Laboratoire de Mathématiques d'Orsay, Université Paris-Saclay CNRS, 91405 Orsay, France (S.F.); Dept of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (O.M., S.M., D. Mitilian, E.F.); Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France (A.S., X.M., S.B., F.P., D. Montani); Inserm UMR_S999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (A.S., D. Montani); Service Hospitalier Frédéric Joliot (SHFJ), CEA/Université Paris-Saclay, Orsay, France (É.B., A.C., F.B., V.L.); Dept of Pathology, Hôpital Marie Lannelongue, 92350 Le Plessis Robinson, France (M.R.G.B.); NeuroSpin, CEA Saclay, Université Paris-Saclay, Gif-sur-Yvette, France and Parietal, INRIA, Palaiseau, 91120, France (H.C.)
| |
Collapse
|
28
|
Martin de Fremont G, Belkhir R, Henry J, Voisin AL, Lambotte O, Besson FL, Mariette X, Nocturne G. Features of polymyalgia rheumatica-like syndrome after immune checkpoint inhibitor therapy. Ann Rheum Dis 2020; 81:e52. [PMID: 32188691 DOI: 10.1136/annrheumdis-2020-217225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/28/2020] [Indexed: 11/04/2022]
Affiliation(s)
| | - Rakiba Belkhir
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Julien Henry
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Anne Laure Voisin
- Unité Fonctionnelle de Pharmacovigilance, Gustave Roussy, F-94800, Villejuif, France
| | - Olivier Lambotte
- Médecine Interne et Immunologie clinique, AP-HP.Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, INSERM, CEA, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes, Le Kremlin-Bicêtre, France
| | - Florent L Besson
- Biophysics and Nuclear Medicine, AP-HP.Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,UMR BioMaps, Inserm/CNRS/CEA/Université Paris-Saclay, Orsay, France
| | - Xavier Mariette
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, INSERM, CEA, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes, Le Kremlin-Bicêtre, France
| | - Gaetane Nocturne
- Rheumatology, AP-HP, Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, INSERM, CEA, Centre de recherche en Immunologie des infections virales et des maladies auto-immunes, Le Kremlin-Bicêtre, France
| |
Collapse
|
29
|
Rozenblum L, Mokrane FZ, Yeh R, Sinigaglia M, Besson FL, Seban RD, Zadro C, Dierickx L, Chougnet CN, Partouche E, Revel-Mouroz P, Zhao B, Otal P, Schwartz LH, Dercle L. Imaging-guided precision medicine in non-resectable gastro-entero-pancreatic neuroendocrine tumors: A step-by-step approach. Eur J Radiol 2020; 122:108743. [DOI: 10.1016/j.ejrad.2019.108743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/11/2019] [Indexed: 12/11/2022]
|
30
|
Sinigaglia M, Assi T, Besson FL, Ammari S, Edjlali M, Feltus W, Rozenblum-Beddok L, Zhao B, Schwartz LH, Mokrane FZ, Dercle L. Imaging-guided precision medicine in glioblastoma patients treated with immune checkpoint modulators: research trend and future directions in the field of imaging biomarkers and artificial intelligence. EJNMMI Res 2019; 9:78. [PMID: 31432278 PMCID: PMC6702257 DOI: 10.1186/s13550-019-0542-5] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/19/2019] [Indexed: 12/14/2022] Open
Abstract
Immunotherapies that employ immune checkpoint modulators (ICMs) have emerged as an effective treatment for a variety of solid cancers, as well as a paradigm shift in the treatment of cancers. Despite this breakthrough, the median survival time of glioblastoma patients has remained at about 2 years. Therefore, the safety and anti-cancer efficacy of combination therapies that include ICMs are being actively investigated. Because of the distinct mechanisms of ICMs, which restore the immune system’s anti-tumor capacity, unconventional immune-related phenomena are increasingly being reported in terms of tumor response and progression, as well as adverse events. Indeed, immunotherapy response assessments for neuro-oncology (iRANO) play a central role in guiding cancer patient management and define a “wait and see strategy” for patients treated with ICMs in monotherapy with progressive disease on MRI. This article deciphers emerging research trends to ameliorate four challenges unaddressed by the iRANO criteria: (1) patient selection, (2) identification of immune-related phenomena other than pseudoprogression (i.e., hyperprogression, the abscopal effect, immune-related adverse events), (3) response assessment in combination therapies including ICM, and (4) alternatives to MRI. To this end, our article provides a structured approach for standardized selection and reporting of imaging modalities to enable the use of precision medicine by deciphering the characteristics of the tumor and its immune environment. Emerging preclinical or clinical innovations are also discussed as future directions such as immune-specific targeting and implementation of artificial intelligence algorithms.
Collapse
Affiliation(s)
- Mathieu Sinigaglia
- Department of Imaging Nuclear Medicine, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Tarek Assi
- Département de médecine oncologique, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Florent L Besson
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 78 rue du Général Leclerc, 94275, Le Kremlin-Bicêtre, France.,IR4M-UMR 8081, CNRS, Université Paris Sud, Université Paris Saclay, Orsay, France
| | - Samy Ammari
- Département d'imagerie médicale, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Myriam Edjlali
- INSERM U894, Service d'imagerie morphologique et fonctionnelle, Hôpital Sainte-Anne, Université Paris Descartes, 1, rue Cabanis, 75014, Paris, France
| | - Whitney Feltus
- Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, New York, NY, 10039, USA
| | - Laura Rozenblum-Beddok
- Service de Médecine Nucléaire, AP-HP, Hôpital La Pitié-Salpêtrière, Sorbonne Université, 75013, Paris, France
| | - Binsheng Zhao
- Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, New York, NY, 10039, USA
| | - Lawrence H Schwartz
- Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, New York, NY, 10039, USA
| | - Fatima-Zohra Mokrane
- Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, New York, NY, 10039, USA.,Département d'imagerie médicale, CHU Rangueil, Université Toulouse Paul Sabatier, Toulouse, France
| | - Laurent Dercle
- Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, New York, NY, 10039, USA. .,UMR1015, Institut Gustave Roussy, Université Paris Saclay, 94800, Villejuif, France.
| |
Collapse
|
31
|
Keraen J, Blanc E, Besson FL, Leguern V, Meyer C, Henry J, Belkhir R, Nocturne G, Mariette X, Seror R. Usefulness of
18
F‐Labeled Fluorodeoxyglucose–Positron Emission Tomography for the Diagnosis of Lymphoma in Primary Sjögren's Syndrome. Arthritis Rheumatol 2019; 71:1147-1157. [DOI: 10.1002/art.40829] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/03/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Jérémy Keraen
- Université Paris‐Sud, AP‐HPHôpitaux Universitaires Paris‐SudINSERM U1184 Le Kremlin‐Bicêtre France
| | - Estelle Blanc
- Centre Chirurgicale Marie Lannelongue Le Plessis‐Robinson France
| | - Florent L. Besson
- Hôpitaux Universitaires Paris‐Sud, AP‐HP, Le‐Kremlin Bicêtre, Franceand IR4M, UMR 8081, Université Paris Saclay, Université Paris‐Sud, CNRS Orsay France
| | - Véronique Leguern
- Université Paris Descartes‐SorbonneAP‐HP, Hôpital Cochin, Paris, Franceand Hôpitaux Universitaires Paris‐Sud Le Kremlin‐Bicêtre France
| | - Céline Meyer
- Hôpitaux Universitaires Paris‐Sud, AP‐HP, Le‐Kremlin Bicêtre, Franceand IR4M, UMR 8081, Université Paris Saclay, Université Paris‐Sud, CNRS Orsay France
| | - Julien Henry
- Université Paris‐Sud, AP‐HPHôpitaux Universitaires Paris‐SudINSERM U1184 Le Kremlin‐Bicêtre France
| | - Rakiba Belkhir
- Université Paris‐Sud, AP‐HPHôpitaux Universitaires Paris‐SudINSERM U1184 Le Kremlin‐Bicêtre France
| | - Gaétane Nocturne
- Université Paris‐Sud, AP‐HPHôpitaux Universitaires Paris‐SudINSERM U1184 Le Kremlin‐Bicêtre France
| | - Xavier Mariette
- Université Paris‐Sud, AP‐HPHôpitaux Universitaires Paris‐SudINSERM U1184 Le Kremlin‐Bicêtre France
| | - Raphaèle Seror
- Université Paris‐Sud, AP‐HPHôpitaux Universitaires Paris‐SudINSERM U1184 Le Kremlin‐Bicêtre France
| |
Collapse
|
32
|
Besson FL, Henry T, Meyer C, Chevance V, Roblot V, Blanchet E, Arnould V, Grimon G, Chekroun M, Mabille L, Parent F, Seferian A, Bulifon S, Montani D, Humbert M, Chaumet-Riffaud P, Lebon V, Durand E. Rapid Contour-based Segmentation for 18F-FDG PET Imaging of Lung Tumors by Using ITK-SNAP: Comparison to Expert-based Segmentation. Radiology 2018; 288:277-284. [DOI: 10.1148/radiol.2018171756] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
33
|
Dejaco C, Ramiro S, Duftner C, Besson FL, Bley TA, Blockmans D, Brouwer E, Cimmino MA, Clark E, Dasgupta B, Diamantopoulos AP, Direskeneli H, Iagnocco A, Klink T, Neill L, Ponte C, Salvarani C, Slart RHJA, Whitlock M, Schmidt WA. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis 2018; 77:636-643. [DOI: 10.1136/annrheumdis-2017-212649] [Citation(s) in RCA: 504] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/13/2017] [Accepted: 01/02/2018] [Indexed: 12/13/2022]
Abstract
To develop evidence-based recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV) including giant cell arteritis (GCA) and Takayasu arteritis (TAK). European League Against Rheumatism (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound, MRI, CT and [18F]-fluorodeoxyglucose positron emission tomography (PET) in LVV. Based on evidence and expert opinion, the task force consisting of 20 physicians, healthcare professionals and patients from 10 EULAR countries developed recommendations, with consensus obtained through voting. The final level of agreement was voted anonymously. A total of 12 recommendations have been formulated. The task force recommends an early imaging test in patients with suspected LVV, with ultrasound and MRI being the first choices in GCA and TAK, respectively. CT or PET may be used alternatively. In case the diagnosis is still in question after clinical examination and imaging, additional investigations including temporal artery biopsy and/or additional imaging are required. In patients with a suspected flare, imaging might help to better assess disease activity. The frequency and choice of imaging modalities for long-term monitoring of structural damage remains an individual decision; close monitoring for aortic aneurysms should be conducted in patients at risk for this complication. All imaging should be performed by a trained specialist using appropriate operational procedures and settings. These are the first EULAR recommendations providing up-to-date guidance for the role of imaging in the diagnosis and monitoring of patients with (suspected) LVV.
Collapse
|
34
|
Roblot V, Henry J, Meyer C, Henry T, Chekroun M, Grimon G, Seror R, Durand E, Besson FL. 18F-FDG PET/CT of extensive rheumatoid nodulosis. Eur J Nucl Med Mol Imaging 2017; 44:2333-2334. [DOI: 10.1007/s00259-017-3825-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/31/2017] [Indexed: 11/24/2022]
|
35
|
Gomez L, Chaumet-Riffaud P, Noel N, Lambotte O, Goujard C, Durand E, Besson FL. Effect of CRP value on 18F-FDG PET vascular positivity in Takayasu arteritis: a systematic review and per-patient based meta-analysis. Eur J Nucl Med Mol Imaging 2017; 45:575-581. [PMID: 28856429 DOI: 10.1007/s00259-017-3798-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 08/03/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study was to quantify the association between the CRP value and 18F-FDG PET vascular positivity in Takayasu arteritis (TAK) through a structured dedicated systematic review and meta-analysis. METHODS From January 2000 to December 2016, the PubMed/MEDLINE database was searched for articles specifically dealing with the assessment of vascular inflammation using 18F-FDG PET and CRP biomarkers in TAK. Inclusion criteria for the qualitative analysis were (1) 18F-FDG PET used to assess the disease activity, (2) The use of the ACR criteria for the diagnosis of TAK, (3) No case mixed vasculitis (i.e., no giant cell arteritis), and (4) CRP concentration and clinical disease activity available. For the meta-analysis, PET-positive and PET-negative subgroups with the corresponding CRP concentrations were generated based on per patient data. The standard mean difference, which represents the effect of the CRP concentrations on the 18F-FDG PET vascular uptake, was computed for all studies, and then the results were pooled together. RESULTS Among the 33 initial citations, nine complete articles including 210 patients fulfilled the inclusion criteria. Five studies found a significant correlation between the 18F-FDG PET and CRP concentration, one provided a trend towards association and three did not find any association between the two biomarkers. Six studies found a significant association between 18F-FDG PET and clinical disease activity, one found a trend towards association and the last two studies did not evaluate this correlation. The meta-analysis (121 patients) provided the following results: Standard Mean Deviation = 0.54 [0.15;0.92]; Chi2 = 3.35; I2 = 0%; Test for overall effect: Z = 2.70 (P = 0.007). CONCLUSION The CRP concentration only moderately reflects the 18F-FDG PET vascular positivity in TAK, suggesting dissociated information. Standardized longitudinal prospective studies are necessary to assess the value of 18F-FDG PET as an independent biomarker for subtle vascular wall inflammation detection.
Collapse
Affiliation(s)
- Léa Gomez
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
| | - Philippe Chaumet-Riffaud
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
| | - Nicolas Noel
- Department of Internal Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- INSERM UMR 1184, Immunologie des Maladies Virales et Autoimmunes (IMVA), Université Paris Sud, Le Kremlin Bicêtre, France
- CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris, France
| | - Olivier Lambotte
- Department of Internal Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- INSERM UMR 1184, Immunologie des Maladies Virales et Autoimmunes (IMVA), Université Paris Sud, Le Kremlin Bicêtre, France
- CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris, France
| | - Cécile Goujard
- Department of Internal Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- CEA, DSV/iMETI, Division of Immuno-Virology IDMIT, Paris, France
- INSERM U1018, CESP, Le Kremlin Bicêtre, France
| | - Emmanuel Durand
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France
- Université Paris Sud, Le Kremlin Bicêtre, France
- IR4M - UMR8081, Université Paris Sud, Université Paris Saclay, CNRS, 91404, Orsay, France
| | - Florent L Besson
- Department of Biophysics and Nuclear Medicine, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, 94275, Le Kremlin-Bicêtre, France.
- Université Paris Sud, Le Kremlin Bicêtre, France.
- IR4M - UMR8081, Université Paris Sud, Université Paris Saclay, CNRS, 91404, Orsay, France.
| |
Collapse
|
36
|
Fouquet M, Besson FL, Gonneaud J, La Joie R, Chételat G. Imaging Brain Effects of APOE4 in Cognitively Normal Individuals Across the Lifespan. Neuropsychol Rev 2014; 24:290-9. [DOI: 10.1007/s11065-014-9263-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/23/2014] [Indexed: 12/21/2022]
|
37
|
Besson FL, La Joie R, Doeuvre L, Gaubert M, Mézenge F, Landeau B, Egret S, Sayette V, Desgranges B, Eustache F, Chetelat G. P1‐212: THE USE OF NEUROIMAGING BIOMARKERS IN PRECLINICAL ALZHEIMER'S DISEASE. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Renaud La Joie
- Helen Will Neuroscience Institue, UC BerkeleyBerkeleyCaliforniaUnited States
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Besson FL, La Joie R, Doeuvre L, Gaubert M, Mézenge F, Landeau B, Egret S, Desgranges B, Eustache F, Chetelat G. IC‐02‐02: THE USE OF NEUROIMAGING BIOMARKERS IN PRECLINICAL ALZHEIMER'S DISEASE. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Renaud La Joie
- Helen Will Neuroscience Institute, UC BerkeleyBerkeleyCaliforniaUnited States
| | | | | | | | | | | | - Béatrice Desgranges
- INSERM, Université de Caen Basse‐Normandie, Ecole Pratique des Hautes Etudes, CHU de CaenCaenFrance
| | | | | |
Collapse
|
39
|
Abstract
In recent years, heart failure has been recognized as a major and increasing public health issue. In the context of the shortage of heart donors and increasing waiting time on the transplantation list, nonpulsatile left ventricular assist devices (LVAD) have shown their efficiency in reducing mortality and improving quality of life in patients with end-stage heart failure. Among LVAD recipients, a minority of patients will recover a normal cardiac function, allowing pump weaning. However, the evaluation of intrinsic cardiac function is particularly challenging and still a matter of debate in LVAD recipients.
Collapse
Affiliation(s)
- Guillaume Coutance
- Department of Cardiology and Vascular Diseases, CHU de Caen, Caen F-14000, France
| | | | | | | | | |
Collapse
|