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Bors S, Abler D, Dietz M, Andrearczyk V, Fageot J, Nicod-Lalonde M, Schaefer N, DeKemp R, Kamani CH, Prior JO, Depeursinge A. Comparing various AI approaches to traditional quantitative assessment of the myocardial perfusion in [ 82Rb] PET for MACE prediction. Sci Rep 2024; 14:9644. [PMID: 38671059 PMCID: PMC11053111 DOI: 10.1038/s41598-024-60095-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Assessing the individual risk of Major Adverse Cardiac Events (MACE) is of major importance as cardiovascular diseases remain the leading cause of death worldwide. Quantitative Myocardial Perfusion Imaging (MPI) parameters such as stress Myocardial Blood Flow (sMBF) or Myocardial Flow Reserve (MFR) constitutes the gold standard for prognosis assessment. We propose a systematic investigation of the value of Artificial Intelligence (AI) to leverage [82 Rb] Silicon PhotoMultiplier (SiPM) PET MPI for MACE prediction. We establish a general pipeline for AI model validation to assess and compare the performance of global (i.e. average of the entire MPI signal), regional (17 segments), radiomics and Convolutional Neural Network (CNN) models leveraging various MPI signals on a dataset of 234 patients. Results showed that all regional AI models significantly outperformed the global model ( p < 0.001 ), where the best AUC of 73.9% (CI 72.5-75.3) was obtained with a CNN model. A regional AI model based on MBF averages from 17 segments fed to a Logistic Regression (LR) constituted an excellent trade-off between model simplicity and performance, achieving an AUC of 73.4% (CI 72.3-74.7). A radiomics model based on intensity features revealed that the global average was the least important feature when compared to other aggregations of the MPI signal over the myocardium. We conclude that AI models can allow better personalized prognosis assessment for MACE.
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Affiliation(s)
- Sacha Bors
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Informatics, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
| | - Daniel Abler
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Informatics, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
| | - Matthieu Dietz
- INSERM U1060, CarMeN laboratory, University of Lyon, Lyon, France
| | - Vincent Andrearczyk
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Informatics, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
| | - Julien Fageot
- AudioVisual Communications Laboratory (LCAV), EPFL, Lausanne, Switzerland
| | - Marie Nicod-Lalonde
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Robert DeKemp
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Christel H Kamani
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland.
- University of Lausanne, Lausanne, Switzerland.
| | - Adrien Depeursinge
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Informatics, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
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Vicino A, Hottinger AF, Latifyan S, Boughdad S, Becce F, Prior JO, Kuntzer T, Brouland JP, Dunet V, Obeid M, Théaudin M. Immune checkpoint inhibitor-related myositis and myocarditis: diagnostic pitfalls and imaging contribution in a real-world, institutional case series. J Neurol 2024; 271:1947-1958. [PMID: 38141128 DOI: 10.1007/s00415-023-12134-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are reshaping the prognosis of many cancers, but often cause immune-related adverse events (irAEs). Among neurological irAEs, myositis is the most frequently reported. Our aim is to describe clinical and non-clinical characteristics, treatment and outcome of all irMyositis (skeletal limb-girdle and/or ocular myositis) and irMyocarditis cases in our reference center. METHODS We retrospectively enrolled all irMyositis/irMyocarditis patients seen between 2018 and 2022. We reviewed demographics, clinical characteristics, biological, neurophysiological, imaging workup, treatment and outcome. RESULTS We included 14 consecutive patients. The most frequent treatments were pembrolizumab (35%) or ipilimumab-nivolumab combination (35%). Limb-girdle, ocular (non-fluctuating palpebral ptosis and/or diplopia with or without ophthalmoparesis) and cardiac phenotypes were equally distributed, overlapping in 40% of cases. Ocular involvement was frequently misdiagnosed; review of brain MRIs disclosed initially missed signs of skeletal myositis in one patient and ocular myositis in 3. Seven patients had other co-existing irAEs. When performed, myography showed a myogenic pattern. CK was elevated in 8/15 patients, troponin-T in 12/12 and troponin-I in 7/9 tested patients. ICI were discontinued in all cases, with further immunosuppressive treatment in nine patients. In most cases, neurological and cardiological outcome was good at last follow-up. CONCLUSION Myositis is a potentially severe irAE. Despite its heterogeneous presentation, some highly suggestive clinical symptoms, such as ocular involvement, or radiological signs should raise physicians' attention to avoid misdiagnosis. We thus recommend a multidisciplinary assessment (including complete neuromuscular evaluation) even in case of isolated myocarditis. Our series underlines the importance of an early diagnosis, since suspension of ICI and adequate treatment are usually associated with good functional outcome.
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Affiliation(s)
- Alex Vicino
- Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Andreas F Hottinger
- Lundin Family Brain Tumor Center, Departments of Oncology and Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sofiya Latifyan
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sarah Boughdad
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thierry Kuntzer
- Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-Philippe Brouland
- Pathology Institute, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Michel Obeid
- Immunology and Allergy Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie Théaudin
- Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Pascual TNB, Paez D, Iagaru A, Gnanasegaran G, Lee ST, Sathekge M, Buatti JM, Giammarile F, Al-Ibraheem A, Pardo MA, Baum RP, De Bari B, Ben-Haim S, Blay JY, Brink A, Estrada-Lobato E, Fanti S, Golubic AT, Hatazawa J, Israel O, Kiess A, Knoll P, Louw L, Mariani G, Mirzaei S, Orellana P, Prior JO, Urbain JL, Vichare S, Vinjamuri S, Virgolini I, Scott AM. Guiding principles on the education and practice of theranostics. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06657-2. [PMID: 38453729 DOI: 10.1007/s00259-024-06657-2] [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: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The recent development and approval of new diagnostic imaging and therapy approaches in the field of theranostics have revolutionised nuclear medicine practice. To ensure the provision of these new imaging and therapy approaches in a safe and high-quality manner, training of nuclear medicine physicians and qualified specialists is paramount. This is required for trainees who are learning theranostics practice, and for ensuring minimum standards for knowledge and competency in existing practising specialists. METHODS To address the need for a training curriculum in theranostics that would be utilised at a global level, a Consultancy Meeting was held at the IAEA in May 2023, with participation by experts in radiopharmaceutical therapy and theranostics including representatives of major international organisations relevant to theranostics practice. RESULTS Through extensive discussions and review of existing curriculum and guidelines, a harmonised training program for theranostics was developed, which aims to ensure safe and high quality theranostics practice in all countries. CONCLUSION The guiding principles for theranostics training outlined in this paper have immediate relevance for the safe and effective practice of theranostics.
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Affiliation(s)
| | - Diana Paez
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Andrei Iagaru
- Division of Nuclear Medicine and Molecular Imaging, Stanford University Medical Center, Stanford, CA, USA
| | - Gopi Gnanasegaran
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK
| | - Sze Ting Lee
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, Australia
- School of Health and Biomedicine, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Mike Sathekge
- Steve Biko Academic Hospital, Pretoria, South Africa
- University of Pretoria, Pretoria, South Africa
| | - John M Buatti
- Department of Radiation Oncology, Holden Comprehensive Cancer Center, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Francesco Giammarile
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- School of Medicine, University of Jordan, Amman, Jordan
| | - Manuela Arevalo Pardo
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Richard P Baum
- Center for Advanced Radiomolecular Precision Oncology, Curanosticum Wiesbaden, FrankfurtWiesbaden, Germany
| | - Berardino De Bari
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland
| | - Simona Ben-Haim
- Department of Biophysics and Nuclear Medicine, Hadassah University Hospital, Jerusalem, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- University College London, London, UK
| | - Jean-Yves Blay
- Department of Medicine, Centre Leon Berard, Lyon, France
- University Claude Bernard Lyon, Lyon, France
| | - Anita Brink
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Enrique Estrada-Lobato
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Stefano Fanti
- Nuclear Medicine Division, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Policlinico S.Orsola, Bologna, Italy
| | - Anja Tea Golubic
- Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ora Israel
- B. Rappaport School of Medicine, Israel Institute of Technology-Technion, Haifa, Israel
| | - Ana Kiess
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Knoll
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Lizette Louw
- Center of Molecular Imaging and Theranostics, Johannesburg, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
| | - Giuliano Mariani
- Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Siroos Mirzaei
- Department of Nuclear Medicine With PET-Centre, Clinic Ottakring, Vienna, Austria
| | | | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Shrikant Vichare
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Sobhan Vinjamuri
- Nuclear Medicine Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Irene Virgolini
- Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.
- School of Cancer Medicine, La Trobe University, Melbourne, Australia.
- Faculty of Medicine, University of Melbourne, Melbourne, Australia.
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Barras D, Ghisoni E, Chiffelle J, Orcurto A, Dagher J, Fahr N, Benedetti F, Crespo I, Grimm AJ, Morotti M, Zimmermann S, Duran R, Imbimbo M, de Olza MO, Navarro B, Homicsko K, Bobisse S, Labes D, Tsourti Z, Andriakopoulou C, Herrera F, Pétremand R, Dummer R, Berthod G, Kraemer AI, Huber F, Thevenet J, Bassani-Sternberg M, Schaefer N, Prior JO, Matter M, Aedo V, Dromain C, Corria-Osorio J, Tissot S, Kandalaft LE, Gottardo R, Pittet M, Sempoux C, Michielin O, Dafni U, Trueb L, Harari A, Laniti DD, Coukos G. Response to tumor-infiltrating lymphocyte adoptive therapy is associated with preexisting CD8 + T-myeloid cell networks in melanoma. Sci Immunol 2024; 9:eadg7995. [PMID: 38306416 DOI: 10.1126/sciimmunol.adg7995] [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: 01/22/2023] [Accepted: 12/06/2023] [Indexed: 02/04/2024]
Abstract
Adoptive cell therapy (ACT) using ex vivo-expanded tumor-infiltrating lymphocytes (TILs) can eliminate or shrink metastatic melanoma, but its long-term efficacy remains limited to a fraction of patients. Using longitudinal samples from 13 patients with metastatic melanoma treated with TIL-ACT in a phase 1 clinical study, we interrogated cellular states within the tumor microenvironment (TME) and their interactions. We performed bulk and single-cell RNA sequencing, whole-exome sequencing, and spatial proteomic analyses in pre- and post-ACT tumor tissues, finding that ACT responders exhibited higher basal tumor cell-intrinsic immunogenicity and mutational burden. Compared with nonresponders, CD8+ TILs exhibited increased cytotoxicity, exhaustion, and costimulation, whereas myeloid cells had increased type I interferon signaling in responders. Cell-cell interaction prediction analyses corroborated by spatial neighborhood analyses revealed that responders had rich baseline intratumoral and stromal tumor-reactive T cell networks with activated myeloid populations. Successful TIL-ACT therapy further reprogrammed the myeloid compartment and increased TIL-myeloid networks. Our systematic target discovery study identifies potential T-myeloid cell network-based biomarkers that could improve patient selection and guide the design of ACT clinical trials.
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Affiliation(s)
- David Barras
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Eleonora Ghisoni
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Johanna Chiffelle
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Angela Orcurto
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Dagher
- Unit of Translational Oncopathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Noémie Fahr
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
| | - Fabrizio Benedetti
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
| | - Isaac Crespo
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
| | - Alizée J Grimm
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
| | - Matteo Morotti
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
| | - Stefan Zimmermann
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Rafael Duran
- Department of Radiology and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Martina Imbimbo
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Maria Ochoa de Olza
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Blanca Navarro
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Krisztian Homicsko
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Sara Bobisse
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Danny Labes
- Flow Cytometry Facility, Department of Formation and Research, University of Lausanne, Epalinges, Switzerland
| | - Zoe Tsourti
- Scientific Research Consulting Hellas, Athens, Greece
| | | | - Fernanda Herrera
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Service of Radiation Oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Rémy Pétremand
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Gregoire Berthod
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Anne I Kraemer
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Florian Huber
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Jonathan Thevenet
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Department of Oncology, Center of Experimental Therapeutics, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Michal Bassani-Sternberg
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Maurice Matter
- Department of Visceral Surgery, Lausanne University Hospital, and University of Lausanne, Lausannne, Switzerland
| | - Veronica Aedo
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Clarisse Dromain
- Department of Radiology and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Jesus Corria-Osorio
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Stéphanie Tissot
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Department of Oncology, Center of Experimental Therapeutics, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Lana E Kandalaft
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Department of Oncology, Center of Experimental Therapeutics, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Raphael Gottardo
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Biomedical Data Science Center and Swiss Institute of Bioinformatics, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Mikaël Pittet
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Christine Sempoux
- Unit of Translational Oncopathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Michielin
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Urania Dafni
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Lionel Trueb
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alexandre Harari
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - Denarda Dangaj Laniti
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
| | - George Coukos
- Ludwig Institute for Cancer Research, Lausanne Branch, Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Agora Cancer Research Center, Lausanne, Switzerland
- Center for Cell Therapy, CHUV-Ludwig Institute, Lausanne, Switzerland
- Service of Immuno-oncology, Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland
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5
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Girardet R, Knebel JF, Dromain C, Vietti Violi N, Tsoumakidou G, Villard N, Denys A, Halkic N, Demartines N, Kobayashi K, Digklia A, Schaefer N, Prior JO, Boughdad S, Duran R. Anatomical Quantitative Volumetric Evaluation of Liver Segments in Hepatocellular Carcinoma Patients Treated with Selective Internal Radiation Therapy: Key Parameters Influencing Untreated Liver Hypertrophy. Cancers (Basel) 2024; 16:586. [PMID: 38339337 PMCID: PMC10854872 DOI: 10.3390/cancers16030586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Factors affecting morphological changes in the liver following selective internal radiation therapy (SIRT) are unclear, and the available literature focuses on non-anatomical volumetric assessment techniques in a lobar treatment setting. This study aimed to investigate quantitative changes in the liver post-SIRT using an anatomical volumetric approach in hepatocellular carcinoma (HCC) patients with different levels of treatment selectivity and evaluate the parameters affecting those changes. This retrospective, single-institution, IRB-approved study included 88 HCC patients. Whole liver, liver segments, tumor burden, and spleen volumes were quantified on MRI at baseline and 3/6/12 months post-SIRT using a segmentation-based 3D software relying on liver vascular anatomy. Treatment characteristics, longitudinal clinical/laboratory, and imaging data were analyzed. The Student's t-test and Wilcoxon test evaluated volumetric parameters evolution. Spearman correlation was used to assess the association between variables. Uni/multivariate analyses investigated factors influencing untreated liver volume (uLV) increase. Results: Most patients were cirrhotic (92%) men (86%) with Child-Pugh A (84%). Absolute and relative uLV kept increasing at 3/6/12 months post-SIRT vs. baseline (all, p ≤ 0.005) and was maximal during the first 6 months. Absolute uLV increase was greater in Child-Pugh A5/A6 vs. ≥B7 at 3 months (A5, p = 0.004; A6, p = 0.007) and 6 months (A5, p = 0.072; A6, p = 0.031) vs. baseline. When the Child-Pugh class worsened at 3 or 6 months post-SIRT, uLV did not change significantly, whereas it increased at 3/6/12 months vs. baseline (all p ≤ 0.015) when liver function remained stable. The Child-Pugh score was inversely correlated with absolute and relative uLV increase at 3 months (rho = -0.21, p = 0.047; rho = -0.229, p = 0.048). In multivariate analysis, uLV increase was influenced at 3 months by younger age (p = 0.013), administered 90Y activity (p = 0.003), and baseline spleen volume (p = 0.023). At 6 months, uLV increase was impacted by younger age (p = 0.006), whereas treatment with glass microspheres (vs. resin) demonstrated a clear trend towards better hypertrophy (f = 3.833, p = 0.058). The amount (percentage) of treated liver strongly impacted the relative uLV increase at 3/6/12 months (all f ≥ 8.407, p ≤ 0.01). Conclusion: Liver function (preserved baseline and stable post-SIRT) favored uLV hypertrophy. Younger patients, smaller baseline spleen volume, higher administered 90Y activity, and a larger amount of treated liver were associated with a higher degree of untreated liver hypertrophy. These factors should be considered in surgical candidates undergoing neoadjuvant SIRT.
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Affiliation(s)
- Raphaël Girardet
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
| | - Jean-François Knebel
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
| | - Clarisse Dromain
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
| | - Naik Vietti Violi
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
| | - Georgia Tsoumakidou
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
| | - Nicolas Villard
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
| | - Alban Denys
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
| | - Nermin Halkic
- Department of Visceral Surgery, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (N.H.); (N.D.); (K.K.)
| | - Nicolas Demartines
- Department of Visceral Surgery, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (N.H.); (N.D.); (K.K.)
| | - Kosuke Kobayashi
- Department of Visceral Surgery, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (N.H.); (N.D.); (K.K.)
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
| | - Antonia Digklia
- Department of Medical Oncology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland;
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (N.S.); (J.O.P.); (S.B.)
| | - John O. Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (N.S.); (J.O.P.); (S.B.)
| | - Sarah Boughdad
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (N.S.); (J.O.P.); (S.B.)
| | - Rafael Duran
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and Lausanne University, 1011 Lausanne, Switzerland; (R.G.); (J.-F.K.); (C.D.); (N.V.V.); (G.T.); (N.V.); (A.D.)
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Nammas W, Paunonen C, Teuho J, Siekkinen R, Luoto P, Käkelä M, Hietanen A, Viljanen T, Dietz M, Prior JO, Li XG, Roivainen A, Knuuti J, Saraste A. Imaging of Myocardial α vβ 3 Integrin Expression for Evaluation of Myocardial Injury After Acute Myocardial Infarction. J Nucl Med 2024; 65:132-138. [PMID: 37973184 DOI: 10.2967/jnumed.123.266148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/27/2023] [Indexed: 11/19/2023] Open
Abstract
[68Ga]Ga-NODAGA-Arg-Gly-Asp (RGD) is a PET tracer targeting αvβ3 integrin, which is upregulated during angiogenesis soon after acute myocardial infarction (AMI). We prospectively evaluated determinants of myocardial uptake of [68Ga]Ga-NODAGA-RGD and its associations with left ventricular (LV) function in patients after AMI. Methods: Myocardial blood flow and [68Ga]Ga-NODAGA-RGD uptake (60 min after injection) were evaluated by PET in 31 patients 7.7 ± 3.8 d after primary percutaneous coronary intervention for ST-elevation AMI. Transthoracic echocardiography of LV function was performed on the day of PET and at the 6-mo follow-up. Results: PET images showed increased uptake of [68Ga]Ga-NODAGA-RGD in the ischemic area at risk (AAR), predominantly in injured myocardial segments. The SUV in the segment with the highest uptake (SUVmax) in the ischemic AAR was higher than the SUVmean of the remote myocardium (0.73 ± 0.16 vs. 0.51 ± 0.11, P < 0.001). Multivariable predictors of [68Ga]Ga-NODAGA-RGD uptake in the AAR included high peak N-terminal pro-B-type natriuretic peptide (P < 0.001), low LV ejection fraction, low global longitudinal strain (P = 0.01), and low longitudinal strain in the AAR (P = 0.01). [68Ga]Ga-NODAGA-RGD uptake corrected for myocardial blood flow and perfusable tissue fraction in the AAR predicted improvement in global longitudinal strain at follow-up (P = 0.002), independent of peak troponin, N-terminal pro-B-type natriuretic peptide, and LV ejection fraction. Conclusion: [68Ga]Ga-NODAGA-RGD uptake shows increased αvβ3 integrin expression in the ischemic AAR early after AMI that is associated with regional and global systolic dysfunction, as well as increased LV filling pressure. Increased [68Ga]Ga-NODAGA-RGD uptake predicts improvement of global LV function 6 mo after AMI.
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Affiliation(s)
- Wail Nammas
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland
| | - Christian Paunonen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Jarmo Teuho
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Reetta Siekkinen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Pauliina Luoto
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Meeri Käkelä
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Ari Hietanen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Tapio Viljanen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Matthieu Dietz
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Xiang-Guo Li
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Department of Chemistry, University of Turku, Turku, Finland; and
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Anne Roivainen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Antti Saraste
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland;
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
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7
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Lenherr A, Boughdad S, Prior JO, Lalonde MN, Filippidis P. Infective aortitis and subacute myocarditis due to Campylobacter fetus. Int J Infect Dis 2024; 138:113-114. [PMID: 38016501 DOI: 10.1016/j.ijid.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Affiliation(s)
- Anaelle Lenherr
- Internal Medicine Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sarah Boughdad
- Nuclear Medicine and Molecular Imaging Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Paraskevas Filippidis
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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8
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Tian M, Zuo C, Cahid Civelek A, Carrio I, Watanabe Y, Kang KW, Murakami K, Prior JO, Zhong Y, Dou X, Yu C, Jin C, Zhou R, Liu F, Li X, Lu J, Zhang H, Wang J. International consensus on clinical use of presynaptic dopaminergic positron emission tomography imaging in parkinsonism. Eur J Nucl Med Mol Imaging 2024; 51:434-442. [PMID: 37789188 DOI: 10.1007/s00259-023-06403-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Presynaptic dopaminergic positron emission tomography (PET) imaging serves as an essential tool in diagnosing and differentiating patients with suspected parkinsonism, including idiopathic Parkinson's disease (PD) and other neurodegenerative and non-neurodegenerative diseases. The PET tracers most commonly used at the present time mainly target dopamine transporters (DAT), aromatic amino acid decarboxylase (AADC), and vesicular monoamine type 2 (VMAT2). However, established standards for the imaging procedure and interpretation of presynaptic dopaminergic PET imaging are still lacking. The goal of this international consensus is to help nuclear medicine practitioners procedurally perform presynaptic dopaminergic PET imaging. METHOD A multidisciplinary task group formed by experts from various countries discussed and approved the consensus for presynaptic dopaminergic PET imaging in parkinsonism, focusing on standardized recommendations, procedures, interpretation, and reporting. CONCLUSION This international consensus and practice guideline will help to promote the standardized use of presynaptic dopaminergic PET imaging in parkinsonism. It will become an international standard for this purpose in clinical practice.
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Affiliation(s)
- Mei Tian
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China.
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Human Phenome Institute, Fudan University, Shanghai, 201203, China.
| | - Chuantao Zuo
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China.
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
| | - A Cahid Civelek
- Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins Medicine, Baltimore, MD, 21287, USA.
| | - Ignasi Carrio
- Research Institute and Department of Nuclear Medicine, Hospital Sant Pau, Autonomous University of Barcelona, 08025, Barcelona, Spain
| | - Yasuyoshi Watanabe
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, 650-0047, Japan
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Koji Murakami
- Department of Radiology, Juntendo University Hospital, Tokyo, 113-8431, Japan
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Yan Zhong
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Xiaofeng Dou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Congcong Yu
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Chentao Jin
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Rui Zhou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Fengtao Liu
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Xinyi Li
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Jiaying Lu
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, China.
- The College of Biomedical Engineering and Instrument Science of Zhejiang University, Hangzhou, 310007, China.
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310007, China.
| | - Jian Wang
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China.
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Andrearczyk V, Oreiller V, Boughdad S, Le Rest CC, Tankyevych O, Elhalawani H, Jreige M, Prior JO, Vallières M, Visvikis D, Hatt M, Depeursinge A. Automatic Head and Neck Tumor segmentation and outcome prediction relying on FDG-PET/CT images: Findings from the second edition of the HECKTOR challenge. Med Image Anal 2023; 90:102972. [PMID: 37742374 DOI: 10.1016/j.media.2023.102972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 07/27/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023]
Abstract
By focusing on metabolic and morphological tissue properties respectively, FluoroDeoxyGlucose (FDG)-Positron Emission Tomography (PET) and Computed Tomography (CT) modalities include complementary and synergistic information for cancerous lesion delineation and characterization (e.g. for outcome prediction), in addition to usual clinical variables. This is especially true in Head and Neck Cancer (HNC). The goal of the HEad and neCK TumOR segmentation and outcome prediction (HECKTOR) challenge was to develop and compare modern image analysis methods to best extract and leverage this information automatically. We present here the post-analysis of HECKTOR 2nd edition, at the 24th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2021. The scope of the challenge was substantially expanded compared to the first edition, by providing a larger population (adding patients from a new clinical center) and proposing an additional task to the challengers, namely the prediction of Progression-Free Survival (PFS). To this end, the participants were given access to a training set of 224 cases from 5 different centers, each with a pre-treatment FDG-PET/CT scan and clinical variables. Their methods were subsequently evaluated on a held-out test set of 101 cases from two centers. For the segmentation task (Task 1), the ranking was based on a Borda counting of their ranks according to two metrics: mean Dice Similarity Coefficient (DSC) and median Hausdorff Distance at 95th percentile (HD95). For the PFS prediction task, challengers could use the tumor contours provided by experts (Task 3) or rely on their own (Task 2). The ranking was obtained according to the Concordance index (C-index) calculated on the predicted risk scores. A total of 103 teams registered for the challenge, for a total of 448 submissions and 29 papers. The best method in the segmentation task obtained an average DSC of 0.759, and the best predictions of PFS obtained a C-index of 0.717 (without relying on the provided contours) and 0.698 (using the expert contours). An interesting finding was that best PFS predictions were reached by relying on DL approaches (with or without explicit tumor segmentation, 4 out of the 5 best ranked) compared to standard radiomics methods using handcrafted features extracted from delineated tumors, and by exploiting alternative tumor contours (automated and/or larger volumes encompassing surrounding tissues) rather than relying on the expert contours. This second edition of the challenge confirmed the promising performance of fully automated primary tumor delineation in PET/CT images of HNC patients, although there is still a margin for improvement in some difficult cases. For the first time, the prediction of outcome was also addressed and the best methods reached relatively good performance (C-index above 0.7). Both results constitute another step forward toward large-scale outcome prediction studies in HNC.
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Affiliation(s)
- Vincent Andrearczyk
- Institute of Informatics, University of Applied Sciences Western Switzerland (HES-SO), Sierre, Switzerland.
| | - Valentin Oreiller
- Institute of Informatics, University of Applied Sciences Western Switzerland (HES-SO), Sierre, Switzerland; Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sarah Boughdad
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Catherine Cheze Le Rest
- LaTIM, INSERM, UMR 1101, University Brest, Brest, France; Poitiers University Hospital, nuclear medicine, Poitiers, France
| | - Olena Tankyevych
- LaTIM, INSERM, UMR 1101, University Brest, Brest, France; Poitiers University Hospital, nuclear medicine, Poitiers, France
| | - Hesham Elhalawani
- Cleveland Clinic Foundation, Department of Radiation Oncology, Cleveland, OH, United States of America
| | - Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Mathieu Hatt
- LaTIM, INSERM, UMR 1101, University Brest, Brest, France
| | - Adrien Depeursinge
- Institute of Informatics, University of Applied Sciences Western Switzerland (HES-SO), Sierre, Switzerland; Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Smet H, Martin D, Uldry E, Duran R, Girardet R, Schaefer N, Prior JO, Denys A, Halkic N, Demartines N, Melloul E. Tc-99m mebrofenin hepatobiliary scintigraphy to assess future liver remnant function before major liver surgery. J Surg Oncol 2023; 128:1312-1319. [PMID: 37638473 DOI: 10.1002/jso.27426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/12/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND AND OBJECTIVES Assessment of liver function is paramount before hepatectomy. This study aimed to assess future liver remnant function (FLR-F) using hepatobiliary scintigraphy (HBS) and to compare it to FLR volume (FLR-V) in the prediction of posthepatectomy liver failure (PHLF). The impact of volume and function gains were also assessed in patients undergoing portal vein embolization (PVE) or liver venous deprivation (LVD). METHODS All consecutive patients undergoing major hepatectomy between 02/2018 and 09/2021 with preoperative HBS were included. FLR-V was expressed as percentage of total liver volume and analyzed using preoperative computed tomography. FLR-V and FLR-F gains after embolization were expressed in percentage. Receiver operating characteristic analysis was performed to compare both methods in predicting PHLF. RESULTS Thirty-six patients were included. PVE and LVD were performed in 4 (11%) and 28 patients (78%), respectively. Overall, PHLF occurred in eight patients (22%). FLR-F gain after embolization showed significant ability to predict PHLF (area under the curve [AUC] = 0.789), with cut-off value of 150% showing a sensitivity of 1.00, a specificity of 0.42, and a negative predictive value of 1.00. CONCLUSION Preoperative HBS shows a high sensitivity to predict PHLF when HBS is performed twice to measure the function gain after venous embolization.
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Affiliation(s)
- Héloïse Smet
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - David Martin
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Emilie Uldry
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Rafaël Duran
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Raphael Girardet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Alban Denys
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Nermin Halkic
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Nicolas Demartines
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Emmanuel Melloul
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), Lausanne, Switzerland
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Champendal M, Müller H, Prior JO, Dos Reis CS. A scoping review of interpretability and explainability concerning artificial intelligence methods in medical imaging. Eur J Radiol 2023; 169:111159. [PMID: 37976760 DOI: 10.1016/j.ejrad.2023.111159] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/26/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To review eXplainable Artificial Intelligence/(XAI) methods available for medical imaging/(MI). METHOD A scoping review was conducted following the Joanna Briggs Institute's methodology. The search was performed on Pubmed, Embase, Cinhal, Web of Science, BioRxiv, MedRxiv, and Google Scholar. Studies published in French and English after 2017 were included. Keyword combinations and descriptors related to explainability, and MI modalities were employed. Two independent reviewers screened abstracts, titles and full text, resolving differences through discussion. RESULTS 228 studies met the criteria. XAI publications are increasing, targeting MRI (n = 73), radiography (n = 47), CT (n = 46). Lung (n = 82) and brain (n = 74) pathologies, Covid-19 (n = 48), Alzheimer's disease (n = 25), brain tumors (n = 15) are the main pathologies explained. Explanations are presented visually (n = 186), numerically (n = 67), rule-based (n = 11), textually (n = 11), and example-based (n = 6). Commonly explained tasks include classification (n = 89), prediction (n = 47), diagnosis (n = 39), detection (n = 29), segmentation (n = 13), and image quality improvement (n = 6). The most frequently provided explanations were local (78.1 %), 5.7 % were global, and 16.2 % combined both local and global approaches. Post-hoc approaches were predominantly employed. The used terminology varied, sometimes indistinctively using explainable (n = 207), interpretable (n = 187), understandable (n = 112), transparent (n = 61), reliable (n = 31), and intelligible (n = 3). CONCLUSION The number of XAI publications in medical imaging is increasing, primarily focusing on applying XAI techniques to MRI, CT, and radiography for classifying and predicting lung and brain pathologies. Visual and numerical output formats are predominantly used. Terminology standardisation remains a challenge, as terms like "explainable" and "interpretable" are sometimes being used indistinctively. Future XAI development should consider user needs and perspectives.
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Affiliation(s)
- Mélanie Champendal
- School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, Lausanne, CH, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, CH, Switzerland.
| | - Henning Müller
- Informatics Institute, University of Applied Sciences Western Switzerland (HES-SO Valais) Sierre, CH, Switzerland; Medical faculty, University of Geneva, CH, Switzerland.
| | - John O Prior
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, CH, Switzerland; Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital (CHUV), Lausanne, CH, Switzerland.
| | - Cláudia Sá Dos Reis
- School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, Lausanne, CH, Switzerland.
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Mazini B, Dietz M, Maréchal B, Corredor-Jerez R, Prior JO, Dunet V. Interrelation between cardiac and brain small-vessel disease: a pilot quantitative PET and MRI study. Eur J Hybrid Imaging 2023; 7:20. [PMID: 37926793 PMCID: PMC10625923 DOI: 10.1186/s41824-023-00180-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/14/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Small-vessel disease (SVD) plays a crucial role in cardiac and brain ischemia, but little is known about potential interrelation between both. We retrospectively evaluated 370 patients, aiming at assessing the interrelation between cardiac and brain SVD by using quantitative 82Rb cardiac PET/CT and brain MRI. RESULTS In our population of 370 patients, 176 had normal myocardial perfusion, 38 had pure cardiac SVD and 156 had obstructive coronary artery disease. All underwent both a cardiac 82Rb PET/CT and a brain 1.5T or 3T MRI. Left-ventricle myocardial blood flow (LV-MBF) and flow reserve (LV-MFR) were recorded from 82Rb PET/CT, while Fazekas score, white matter lesion (WMab) volume, deep gray matter lesion (GMab) volume, and brain morphometry (for z-score calculation) using the MorphoBox research application were derived from MRI. Groups were compared with Kruskal-Wallis test, and the potential interrelation between heart and brain SVD markers was assessed using Pearson's correlation coefficient. Patients with cardiac SVD had lower stress LV-MBF and MFR (P < 0.001) than patients with normal myocardial perfusion; Fazekas scores and WMab volumes were similar in those two groups (P > 0.45). In patients with cardiac SVD only, higher rest LV-MBF was associated with a lower left-putamen (rho = - 0.62, P = 0.033), right-thalamus (rho = 0.64, P = 0.026), and right-pallidum (rho = 0.60, P = 0.039) z-scores and with a higher GMab volume. Lower stress LV-MBF was associated with lower left-caudate z-score (rho = 0.69, P = 0.014), while lower LV-MFR was associated with lower left (rho = 0.75, P = 0.005)- and right (rho = 0.59, P = 0.045)-putamen z-scores, as well as higher right-thalamus GMab volume (rho = - 0.72, P = 0.009). CONCLUSION Significant interrelations between cardiac and cerebral SVD markers were found, especially regarding deep gray matter alterations, which supports the hypothesis of SVD as a systemic disease.
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Affiliation(s)
- Bianca Mazini
- Department of Diagnostic and Interventional Radiology, Neuroradiology Unit, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Matthieu Dietz
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
| | - Bénédicte Maréchal
- Department of Diagnostic and Interventional Radiology, Neuroradiology Unit, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland
- LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Ricardo Corredor-Jerez
- Department of Diagnostic and Interventional Radiology, Neuroradiology Unit, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland
- LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
- University of Lausanne, Lausanne, Switzerland.
| | - Vincent Dunet
- Department of Diagnostic and Interventional Radiology, Neuroradiology Unit, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
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13
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Annunziata S, Testart N, Auf der Springe K, Cuzzocrea M, Nicod Lalonde M, Schaefer N, Prior JO, Garibotto V, Treglia G. Contrast enhanced CT on PET/CT imaging in clinical routine: an international survey. Front Med (Lausanne) 2023; 10:1290956. [PMID: 37908847 PMCID: PMC10613639 DOI: 10.3389/fmed.2023.1290956] [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: 09/08/2023] [Accepted: 10/03/2023] [Indexed: 11/02/2023] Open
Abstract
Aim To perform an international survey about PET/CT imaging with contrast enhanced CT (PET/ceCT) in clinical routine worldwide. Methods A questionnaire of ten questions was prepared for health professionals, addressing the following issues: (1) general demographic, hospital, and department information; (2) use and diffusion of PET/ceCT worldwide; (3) factors influencing the use of PET/ceCT. An invitation to the survey was sent to the corresponding authors of NM scientific articles indexed in SCOPUS in 2022 and dedicated to PET/CT imaging. Data were analysed per individual responder. Results 191 individual responders worldwide participated in this survey. Most of the responders are using PET/ceCT in their center (74%). Interestingly, the relative use of PET/ceCT over the total PET/CT scans has an anti-Gaussian distribution (<20% ceCT and > 80% ceCT were most represented). Most of responders are using PET/ceCT in oncological settings (62%) and irrespectively from radiopharmaceuticals (62%). In most cases, PET/ceCT scans are reported by NM physicians alone or together by NM physicians and radiologists with an integrated report (31%). Conclusion PET/ceCT imaging is largely used worldwide. Local factors can affect the choice of PET/ceCT in respect to conventional PET/CT imaging. Further cost-benefit analysis could be useful to consider other possible influencing variables, such as technologies, dosimetry, department organization and economics.
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Affiliation(s)
- Salvatore Annunziata
- Unità di Medicina Nucleare, GSTeP Radiopharmacy, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nathalie Testart
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Katharina Auf der Springe
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Marco Cuzzocrea
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - John O. Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocentre and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland
- Centre for Biomedical Imaging, University of Geneva, Geneva, Switzerland
| | - Giorgio Treglia
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Papadimitriou-Olivgeris M, Monney P, Rotzinger DC, Kamani CH, Fahrni G, Prior JO, Ianculescu N, Messaoudi Y, Tozzi P, Kirsch M, Guery B. Impact of thoracoabdominal imaging on diagnosis and management in patients with suspected infective endocarditis. Eur J Intern Med 2023; 116:82-88. [PMID: 37328399 DOI: 10.1016/j.ejim.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/17/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Embolic events (EEs) are a common complication of infective endocarditis (IE) and their presence can impact diagnosis and modify the therapeutic plan. The present study aimed to describe the role of thoracoabdominal imaging, either thoracoabdominal-pelvic Computed Tomography or 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography, on diagnosis and management of patients with suspected IE. METHODS This study was conducted at a university hospital, from January 2014 to June 2022. EEs and IE were defined according to modified Duke criteria. RESULTS Among 966 episodes with suspected IE and thoracoabdominal imaging, 528 (55%) patients were asymptomatic. At least one EE was found in 205 (21%) episodes. Based on thoracoabdominal imaging findings, the diagnosis was reclassified from rejected to possible or from possible to definite IE in 6 (1%) and 10 (1%) episodes, respectively. Among the 413 patients with IE, at least one EE was found on thoracoabdominal imaging in 143 (35%) episodes. Together with the presence of left-side valvular vegetation >10 mm, the results of thoracoabdominal imaging established a surgical indication (prevention of embolism) in 15 (4%) episodes, 7 of which were asymptomatic. CONCLUSIONS Thoracoabdominal imaging performed in asymptomatic patients with suspected IE improved the diagnosis in only a small proportion of patients. Thoracoabdominal imaging led to a new surgical indication (in association with left-side valvular vegetation >10 mm) in only a small percentage of patients.
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Affiliation(s)
| | - Pierre Monney
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - David C Rotzinger
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Christel H Kamani
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Guillaume Fahrni
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicoleta Ianculescu
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Yosra Messaoudi
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Piergiorgio Tozzi
- Department of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Kirsch
- Department of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Benoit Guery
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Casutt A, Lamoth F, Lortholary O, Prior JO, Tonglet A, Manuel O, Bergeron A, Beigelman-Aubry C. Atypical imaging patterns during lung invasive mould diseases: lessons for clinicians. Eur Respir Rev 2023; 32:230086. [PMID: 37758271 PMCID: PMC10523149 DOI: 10.1183/16000617.0086-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/13/2023] [Indexed: 09/30/2023] Open
Abstract
Imaging of pulmonary invasive mould diseases (IMDs), which represents a cornerstone in their work-up, is mainly based on computed tomography (CT). The purpose of this review is to discuss their CT features, mainly those related to aspergillosis and mucormycosis. We will especially focus on atypical radiological presentations that are increasingly observed among non-neutropenic emerging populations of patients at risk, such as those receiving novel anticancer therapies or those in the intensive care unit. We will also discuss the interest of other available imaging techniques, mainly positron emission tomography/CT, that may play a role in the diagnosis as well as evaluation of disease extent and follow-up. We will show that any new airway-centred abnormality or caveated lesion should evoke IMDs in mildly immunocompromised hosts. Limitations in their recognition may be due to potential underlying abnormalities that increase the complexity of interpretation of lung imaging, as well as the non-specificity of imaging features. In this way, the differentials of all morphological/metabolic aspects must be kept in mind for the optimal management of patients, as well as the benefit of evaluation of the vascular status.
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Affiliation(s)
- Alessio Casutt
- Division of Pulmonology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Division of Pulmonology, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Frédéric Lamoth
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Institute of Microbiology, Department of Laboratories, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Olivier Lortholary
- University Paris Cité, Necker Enfants Malades University Hospital, AP-HP, IHU Imagine, Paris, France
- Institut Pasteur, National Reference Center for Invasive Mycoses and Antifungals, Paris, France
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Andrea Tonglet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Oriol Manuel
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Transplantation Center, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Anne Bergeron
- Department of Pulmonology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
- A. Bergeron and C. Beigelman-Aubry contributed equally to this work
| | - Catherine Beigelman-Aubry
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- A. Bergeron and C. Beigelman-Aubry contributed equally to this work
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Jreige M, Darçot E, Lovis A, Simons J, Nicod-Lalonde M, Schaefer N, Buela F, Long O, Beigelman-Aubry C, Prior JO. Lung CT stabilization with high-frequency non-invasive ventilation (HF-NIV) and breath-hold (BH) in lung nodule assessment by PET/CT. Eur J Hybrid Imaging 2023; 7:16. [PMID: 37661217 PMCID: PMC10475447 DOI: 10.1186/s41824-023-00175-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
PURPOSE To evaluate the effect of lung stabilization using high-frequency non-invasive ventilation (HF-NIV) and breath-hold (BH) techniques on lung nodule detection and texture assessment in PET/CT compared to a free-breathing (FB) standard lung CT acquisition in PET/CT. MATERIALS AND METHODS Six patients aged 65 ± 7 years, addressed for initial assessment of at least one suspicious lung nodule with 18F-FDG PET/CT, underwent three consecutive lung PET/CT acquisitions with FB, HF-NIV and BH. Lung nodules were assessed on all three CT acquisitions of the PET/CT and characterized for any size, volume and solid/sub-solid nature. RESULTS BH detected a significantly higher number of nodules (n = 422) compared to HF-NIV (n = 368) and FB (n = 191) (p < 0.001). The mean nodule size (mm) was 2.4 ± 2.1, 2.6 ± 1.9 and 3.2 ± 2.4 in BH, HF-NIV and FB, respectively, for long axis and 1.5 ± 1.3, 1.6 ± 1.2 and 2.1 ± 1.7 in BH, HF-NIV and FB, respectively, for short axis. Long- and short-axis diameters were significantly different between BH and FB (p < 0.001) and between HF-NIV and FB (p < 0.001 and p = 0.008), but not between BH and HF-NIV. A trend for higher volume was shown in FB compared to BH (p = 0.055) and HF-NIV (p = 0.068) without significant difference between BH and HF-NIV (p = 1). We found a significant difference in detectability of sub-solid nodules between the three acquisitions, with BH showing a higher number of sub-solid nodules (n = 128) compared to HF-NIV (n = 72) and FB (n = 44) (p = 0.002). CONCLUSION We observed a higher detection rate of pulmonary nodules on CT under BH or HF-NIV conditions applied to PET/CT than with FB. BH and HF-NIV demonstrated comparable texture assessment and performed better than FB in assessing size and volume. BH showed a better performance for detecting sub-solid nodules compared to HF-NIV and FB. The addition of BH or HF-NIV to PET/CT can help improve the detection and texture characterization of lung nodules by CT, therefore improving the accuracy of oncological lung disease assessment. The ease of use of BH and its added value should prompt its use in routine practice.
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Affiliation(s)
- Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Emeline Darçot
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alban Lovis
- Department of Pulmonology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Julien Simons
- Department of Physiotherapy, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie Nicod-Lalonde
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Flore Buela
- Department of Physiotherapy, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Long
- Department of Physiotherapy, Lausanne University Hospital, Lausanne, Switzerland
| | - Catherine Beigelman-Aubry
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
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Tabotta F, Gnesin S, Dunet V, Ponti A, Digklia A, Boughdad S, Schaefer N, Prior JO, Villard N, Tsoumakidou G, Denys A, Duran R. 99mTc-macroaggregated albumin SPECT/CT predictive dosimetry and dose-response relationship in uveal melanoma liver metastases treated with first-line selective internal radiation therapy. Sci Rep 2023; 13:13118. [PMID: 37573346 PMCID: PMC10423257 DOI: 10.1038/s41598-023-39994-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 08/03/2023] [Indexed: 08/14/2023] Open
Abstract
First-line selective internal radiation therapy (SIRT) showed promising outcomes in patients with uveal melanoma liver metastases (UMLM). Patient survival depends on liver's disease control. SIRT planning is essential and little is known about dosimetry. We investigated whether 99mTc-MAA-SPECT/CT dosimetry could predict absorbed doses (AD) evaluated on 90Y-PET/CT and assess the dose-response relationship in UMLM patients treated with first-line SIRT. This IRB-approved, single-center, retrospective analysis (prospectively collected cohort) included 12 patients (median age 63y, range 43-82). Patients underwent MRI/CT, 18F-FDG-PET/CT before and 3-6 months post-SIRT, and 90Y-PET/CT immediately post-SIRT. Thirty-two target lesions were included. AD estimates in tumor and non-tumor liver were obtained from 99mTc-MAA-SPECT/CT and post-SIRT 90Y-PET/CT, and assessed with Lin's concordance correlation coefficients (ρc and Cb), Pearson's coefficient correlation (ρ), and Bland-Altman analyses (mean difference ± standard deviation; 95% limits-of-agreement (LOA)). Influence of tumor characteristics and microsphere type on AD was analyzed. Tumor response was assessed according to size-based, enhancement-based and metabolic response criteria. Mean target lesion AD was 349 Gy (range 46-1586 Gy). Concordance between 99mTc-MAA-SPECT/CT and 90Y-PET/CT tumor dosimetry improved upon dose correction for the recovery coefficient (RC) (ρ = 0.725, ρc = 0.703, Cb = 0.969) with good agreement (mean difference: - 4.93 ± 218.3 Gy, 95%LOA: - 432.8-422.9). Without RC correction, concordance was better for resin microspheres (ρ = 0.85, ρc = 0.998, Cb = 0.849) and agreement was very good between predictive 99mTc-MAA-SPECT/CT and 90Y-PET/CT dosimetry (mean difference: - 4.05 ± 55.9 Gy; 95%LOA: - 113.7-105.6). After RC correction, 99mTc-MAA-SPECT/CT dosimetry overestimated AD (- 70.9 ± 158.9 Gy; 95%LOA: - 382.3-240.6). For glass microspheres, concordance markedly improved with RC correction (ρ = 0.790, ρc = 0.713, Cb = 0.903 vs without correction: ρ = 0.395, ρc = 0.244, Cb = 0.617) and 99mTc-MAA-SPECT/CT dosimetry underestimated AD (148.9 ± 267.5 Gy; 95%LOA: - 375.4-673.2). For non-tumor liver, concordance was good between 99mTc-MAA-SPECT/CT and 90Y-PET/CT dosimetry (ρ = 0.942, ρc = 0.852, Cb = 0.904). 99mTc-MAA-SPECT/CT slightly overestimated liver AD for resin (3.4 ± 3.4 Gy) and glass (11.5 ± 13.9 Gy) microspheres. Tumor AD was not correlated with baseline or post-SIRT lesion characteristics and no dose-response threshold could be identified. 99mTc-MAA-SPECT/CT dosimetry provides good estimates of AD to tumor and non-tumor liver in UMLM patients treated with first-line SIRT.
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Affiliation(s)
- Flavian Tabotta
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Silvano Gnesin
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alexandre Ponti
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antonia Digklia
- Department of Medical Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sarah Boughdad
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicolas Villard
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Georgia Tsoumakidou
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alban Denys
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Rafael Duran
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Hajri R, Nicod-Lalonde M, Hottinger AF, Prior JO, Dunet V. Prediction of Glioma Grade and IDH Status Using 18F-FET PET/CT Dynamic and Multiparametric Texture Analysis. Diagnostics (Basel) 2023; 13:2604. [PMID: 37568967 PMCID: PMC10417545 DOI: 10.3390/diagnostics13152604] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
Mutations in isocitrate dehydrogenase (IDH) represent an independent predictor of better survival in patients with gliomas. We aimed to assess grade and IDH mutation status in patients with untreated gliomas, by evaluating the respective value of 18F-FET PET/CT via dynamic and texture analyses. A total of 73 patients (male: 48, median age: 47) who underwent an 18F-FET PET/CT for initial glioma evaluation were retrospectively included. IDH status was available in 61 patients (20 patients with WHO grade 2 gliomas, 41 with grade 3-4 gliomas). Time-activity curve type and 20 parameters obtained from static analysis using LIFEx© v6.30 software were recorded. Respective performance was assessed using receiver operating characteristic curve analysis and stepwise multivariate regression analysis adjusted for patients' age and sex. The time-activity curve type and texture parameters derived from the static parameters showed satisfactory-to-good performance in predicting glioma grade and IDH status. Both time-activity curve type (stepwise OR: 101.6 (95% CI: 5.76-1791), p = 0.002) and NGLDM coarseness (stepwise OR: 2.08 × 1043 (95% CI: 2.76 × 1012-1.57 × 1074), p = 0.006) were independent predictors of glioma grade. No independent predictor of IDH status was found. Dynamic and texture analyses of 18F-FET PET/CT have limited predictive value for IDH status when adjusted for confounding factors. However, they both help predict glioma grade.
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Affiliation(s)
- Rami Hajri
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland;
| | - Marie Nicod-Lalonde
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland; (M.N.-L.); (J.O.P.)
| | - Andreas F. Hottinger
- Department of Neurology, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland;
- Lukas Lundin & Family Brain Tumor Research Center, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland
| | - John O. Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland; (M.N.-L.); (J.O.P.)
| | - Vincent Dunet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland;
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Courlet P, Abler D, Guidi M, Girard P, Amato F, Vietti Violi N, Dietz M, Guignard N, Wicky A, Latifyan S, De Micheli R, Jreige M, Dromain C, Csajka C, Prior JO, Venkatakrishnan K, Michielin O, Cuendet MA, Terranova N. Modeling tumor size dynamics based on real-world electronic health records and image data in advanced melanoma patients receiving immunotherapy. CPT Pharmacometrics Syst Pharmacol 2023; 12:1170-1181. [PMID: 37328961 PMCID: PMC10431051 DOI: 10.1002/psp4.12983] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 06/18/2023] Open
Abstract
The development of immune checkpoint inhibitors (ICIs) has revolutionized cancer therapy but only a fraction of patients benefits from this therapy. Model-informed drug development can be used to assess prognostic and predictive clinical factors or biomarkers associated with treatment response. Most pharmacometric models have thus far been developed using data from randomized clinical trials, and further studies are needed to translate their findings into the real-world setting. We developed a tumor growth inhibition model based on real-world clinical and imaging data in a population of 91 advanced melanoma patients receiving ICIs (i.e., ipilimumab, nivolumab, and pembrolizumab). Drug effect was modeled as an ON/OFF treatment effect, with a tumor killing rate constant identical for the three drugs. Significant and clinically relevant covariate effects of albumin, neutrophil to lymphocyte ratio, and Eastern Cooperative Oncology Group (ECOG) performance status were identified on the baseline tumor volume parameter, as well as NRAS mutation on tumor growth rate constant using standard pharmacometric approaches. In a population subgroup (n = 38), we had the opportunity to conduct an exploratory analysis of image-based covariates (i.e., radiomics features), by combining machine learning and conventional pharmacometric covariate selection approaches. Overall, we demonstrated an innovative pipeline for longitudinal analyses of clinical and imaging RWD with a high-dimensional covariate selection method that enabled the identification of factors associated with tumor dynamics. This study also provides a proof of concept for using radiomics features as model covariates.
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Affiliation(s)
- Perrine Courlet
- Precision Oncology Center, Department of OncologyLausanne University Hospital and University of LausanneLausanneSwitzerland
- Centre for Research and Innovation in Clinical Pharmaceutical SciencesLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Daniel Abler
- Precision Oncology Center, Department of OncologyLausanne University Hospital and University of LausanneLausanneSwitzerland
- Institute of Informatics, School of Management, University of Applied Sciences Western Switzerland (HES‐SO)SierreSwitzerland
| | - Monia Guidi
- Centre for Research and Innovation in Clinical Pharmaceutical SciencesLausanne University Hospital and University of LausanneLausanneSwitzerland
- Service of Clinical PharmacologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Pascal Girard
- Merck Institute of Pharmacometrics, Ares Trading S.A. (an affiliate of Merck KGaA, Darmstadt, Germany)LausanneSwitzerland
| | - Federico Amato
- Swiss Data Science Centre, École Polytechnique Fédérale de Lausanne (EPFL) and Eidgenössische Technische Hochschule Zurich (ETH)ZurichSwitzerland
| | - Naik Vietti Violi
- Department of Radiology and Interventional RadiologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Matthieu Dietz
- Nuclear Medicine and Molecular Imaging DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Nicolas Guignard
- Department of Radiology and Interventional RadiologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Alexandre Wicky
- Precision Oncology Center, Department of OncologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Sofiya Latifyan
- Department of OncologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Rita De Micheli
- Department of OncologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Mario Jreige
- Nuclear Medicine and Molecular Imaging DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Clarisse Dromain
- Department of Radiology and Interventional RadiologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Chantal Csajka
- Centre for Research and Innovation in Clinical Pharmaceutical SciencesLausanne University Hospital and University of LausanneLausanneSwitzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of GenevaUniversity of LausanneGenevaSwitzerland
- School of Pharmaceutical SciencesUniversity of GenevaGenevaSwitzerland
| | - John O. Prior
- Nuclear Medicine and Molecular Imaging DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | | | - Olivier Michielin
- Precision Oncology Center, Department of OncologyLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Michel A. Cuendet
- Precision Oncology Center, Department of OncologyLausanne University Hospital and University of LausanneLausanneSwitzerland
- Swiss Institute of Bioinformatics, University of LausanneLausanneSwitzerland
- Department of Physiology and Biophysics, Weill Cornell MedicineNew YorkNew YorkUSA
| | - Nadia Terranova
- Merck Institute of Pharmacometrics, Ares Trading S.A. (an affiliate of Merck KGaA, Darmstadt, Germany)LausanneSwitzerland
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20
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Dietz M, Kamani CH, Allenbach G, Rubimbura V, Fournier S, Dunet V, Treglia G, Nicod Lalonde M, Schaefer N, Eeckhout E, Muller O, Prior JO. Comparison of the prognostic value of impaired stress myocardial blood flow, myocardial flow reserve, and myocardial flow capacity on low-dose Rubidium-82 SiPM PET/CT. J Nucl Cardiol 2023; 30:1385-1395. [PMID: 36574175 PMCID: PMC10371877 DOI: 10.1007/s12350-022-03155-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/26/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND The most reliable quantitative variable on Rubidium-82 (82Rb) cardiac PET/CT for predicting major adverse cardiovascular events (MACE) has not been characterized with low-dose silicon photomultipliers (SiPM) technology, which allows halving injected activity and radiation dose delivering less than 1.0 mSv in a 70-kg individual. METHODS AND RESULTS We prospectively enrolled 234 consecutive participants with suspected myocardial ischemia. Participants underwent 82Rb cardiac SiPM PET/CT (5 MBq/kg) and were followed up for MACE over 652 days (interquartile range 559-751 days). For each participant, global stress myocardial blood flow (stress MBF), global myocardial flow reserve (MFR), and regional severely reduced myocardial flow capacity (MFCsevere) were measured. The Youden index was used to select optimal thresholds. In multivariate analysis after adjustments for clinical risk factors, reduced global stress MBF < 1.94 ml/min/g, reduced global MFR < 1.98, and regional MFCsevere > 3.2% of left ventricle emerged all as independent predictors of MACE (HR 4.5, 3.1, and 3.67, respectively, p < 0.001). However, only reduced global stress MBF remained an independent prognostic factor for MACE after adjusting for clinical risk factors and the combined use of global stress MBF, global MFR, and regional MFCsevere impairments (HR 2.81, p = 0.027). CONCLUSION Using the latest SiPM PET technology with low-dose 82Rb halving the standard activity to deliver < 1 mSv for a 70-kg patient, impaired global stress MBF, global MFR, and regional MFC were powerful predictors of cardiovascular events, outperforming traditional cardiovascular risk factors. However, only reduced global stress MBF independently predicted MACE, being superior to global MFR and regional MFC impairments.
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Affiliation(s)
- Matthieu Dietz
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
| | - Christel H Kamani
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- Department of Cardiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Gilles Allenbach
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- Nuclear Medicine Department, Fribourg Hospital HFR, Fribourg, Switzerland
| | - Vladimir Rubimbura
- Department of Cardiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Vincent Dunet
- University of Lausanne, Lausanne, Switzerland
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Giorgio Treglia
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Università Della Svizzera Italiana, Lugano, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Eric Eeckhout
- Department of Cardiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
- University of Lausanne, Lausanne, Switzerland.
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21
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Tian M, Zuo C, Civelek AC, Carrio I, Watanabe Y, Kang KW, Murakami K, Garibotto V, Prior JO, Barthel H, Guan Y, Lu J, Zhou R, Jin C, Wu S, Zhang X, Zhong Y, Zhang H. International Nuclear Medicine Consensus on the Clinical Use of Amyloid Positron Emission Tomography in Alzheimer's Disease. Phenomics 2023; 3:375-389. [PMID: 37589025 PMCID: PMC10425321 DOI: 10.1007/s43657-022-00068-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 08/18/2023]
Abstract
Alzheimer's disease (AD) is the main cause of dementia, with its diagnosis and management remaining challenging. Amyloid positron emission tomography (PET) has become increasingly important in medical practice for patients with AD. To integrate and update previous guidelines in the field, a task group of experts of several disciplines from multiple countries was assembled, and they revised and approved the content related to the application of amyloid PET in the medical settings of cognitively impaired individuals, focusing on clinical scenarios, patient preparation, administered activities, as well as image acquisition, processing, interpretation and reporting. In addition, expert opinions, practices, and protocols of prominent research institutions performing research on amyloid PET of dementia are integrated. With the increasing availability of amyloid PET imaging, a complete and standard pipeline for the entire examination process is essential for clinical practice. This international consensus and practice guideline will help to promote proper clinical use of amyloid PET imaging in patients with AD.
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Affiliation(s)
- Mei Tian
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235 China
- Human Phenome Institute, Fudan University, Shanghai, 201203 China
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235 China
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Ali Cahid Civelek
- Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins Medicine, Baltimore, 21287 USA
| | - Ignasi Carrio
- Department of Nuclear Medicine, Hospital Sant Pau, Autonomous University of Barcelona, Barcelona, 08025 Spain
| | - Yasuyoshi Watanabe
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047 Japan
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080 Korea
| | - Koji Murakami
- Department of Radiology, Juntendo University Hospital, Tokyo, 113-8431 Japan
| | - Valentina Garibotto
- Diagnostic Department, University Hospitals of Geneva and NIMTlab, University of Geneva, Geneva, 1205 Switzerland
| | - John O. Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, 1011 Switzerland
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, 04103 Germany
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235 China
| | - Jiaying Lu
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235 China
| | - Rui Zhou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
| | - Chentao Jin
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
| | - Shuang Wu
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
| | - Xiaohui Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
| | - Yan Zhong
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009 China
- The College of Biomedical Engineering and Instrument Science of Zhejiang University, Hangzhou, 310007 China
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310007 China
| | - Molecular Imaging-Based Precision Medicine Task Group of A3 (China-Japan-Korea) Foresight Program
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235 China
- Human Phenome Institute, Fudan University, Shanghai, 201203 China
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 China
- National Center for Neurological Disorders and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040 China
- Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins Medicine, Baltimore, 21287 USA
- Department of Nuclear Medicine, Hospital Sant Pau, Autonomous University of Barcelona, Barcelona, 08025 Spain
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047 Japan
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080 Korea
- Department of Radiology, Juntendo University Hospital, Tokyo, 113-8431 Japan
- Diagnostic Department, University Hospitals of Geneva and NIMTlab, University of Geneva, Geneva, 1205 Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, 1011 Switzerland
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, 04103 Germany
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009 China
- The College of Biomedical Engineering and Instrument Science of Zhejiang University, Hangzhou, 310007 China
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310007 China
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22
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Lalonde MN, Correia RD, Syktiotis GP, Schaefer N, Matter M, Prior JO. Parathyroid Imaging. Semin Nucl Med 2023; 53:490-502. [PMID: 36922339 DOI: 10.1053/j.semnuclmed.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 02/13/2023] [Indexed: 03/17/2023]
Abstract
Primary hyperparathyroidism (1° HPT) is a relatively common endocrine disorder usually caused by autonomous secretion of parathormone by one or several parathyroid adenomas. 1° HPT causing hypercalcemia, kidney stones and/or osteoporosis should be treated whenever possible by parathyroidectomy. Accurate preoperative location of parathyroid adenomas is crucial for surgery planning, mostly when performing minimally invasive surgery. Cervical ultrasonography (US) is usually performed to localize parathyroid adenomas as a first intention, followed by 99mTc- sestamibi scintigraphy with SPECT/CT whenever possible. 4D-CT is a possible alternative to 99mTc- sestamibi scintigraphy. Recently, 18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) has made its way in the clinics as it is the most sensitive method for parathyroid adenoma detection. It can eventually be combined to 4D-CT to increase its diagnostic performance, although this results in higher dose exposure to the patient. Other forms of hyperparathyroidism consist in secondary (2° HPT) and tertiary hyperparathyroidism (3° HPT). As parathyroidectomy is not usually part of the management of patients with 2° HPT, parathyroid imaging is not routinely performed in these patients. In patients with 3° HPT, total or subtotal parathyroidectomy is often performed. Localization of hyperfunctional glands is an important aid to surgery planning. As 18F-FCH PET/CT is the most sensitive modality in multigland disease, it is the preferred imaging technic in 3° HPT patients, although its cost and availability may limit its widespread use in this setting.
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Affiliation(s)
- Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Ricardo Dias Correia
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Gerasimos P Syktiotis
- Diabetology and Endocrinology Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Niklaus Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Maurice Matter
- Visceral Surgery Department, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland.
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23
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Schaefferkoetter J, Shah V, Hayden C, Prior JO, Zuehlsdorff S. Deep learning for improving PET/CT attenuation correction by elastic registration of anatomical data. Eur J Nucl Med Mol Imaging 2023; 50:2292-2304. [PMID: 36882577 DOI: 10.1007/s00259-023-06181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND For PET/CT, the CT transmission data are used to correct the PET emission data for attenuation. However, subject motion between the consecutive scans can cause problems for the PET reconstruction. A method to match the CT to the PET would reduce resulting artifacts in the reconstructed images. PURPOSE This work presents a deep learning technique for inter-modality, elastic registration of PET/CT images for improving PET attenuation correction (AC). The feasibility of the technique is demonstrated for two applications: general whole-body (WB) imaging and cardiac myocardial perfusion imaging (MPI), with a specific focus on respiratory and gross voluntary motion. MATERIALS AND METHODS A convolutional neural network (CNN) was developed and trained for the registration task, comprising two distinct modules: a feature extractor and a displacement vector field (DVF) regressor. It took as input a non-attenuation-corrected PET/CT image pair and returned the relative DVF between them-it was trained in a supervised fashion using simulated inter-image motion. The 3D motion fields produced by the network were used to resample the CT image volumes, elastically warping them to spatially match the corresponding PET distributions. Performance of the algorithm was evaluated in different independent sets of WB clinical subject data: for recovering deliberate misregistrations imposed in motion-free PET/CT pairs and for improving reconstruction artifacts in cases with actual subject motion. The efficacy of this technique is also demonstrated for improving PET AC in cardiac MPI applications. RESULTS A single registration network was found to be capable of handling a variety of PET tracers. It demonstrated state-of-the-art performance in the PET/CT registration task and was able to significantly reduce the effects of simulated motion imposed in motion-free, clinical data. Registering the CT to the PET distribution was also found to reduce various types of AC artifacts in the reconstructed PET images of subjects with actual motion. In particular, liver uniformity was improved in the subjects with significant observable respiratory motion. For MPI, the proposed approach yielded advantages for correcting artifacts in myocardial activity quantification and potentially for reducing the rate of the associated diagnostic errors. CONCLUSION This study demonstrated the feasibility of using deep learning for registering the anatomical image to improve AC in clinical PET/CT reconstruction. Most notably, this improved common respiratory artifacts occurring near the lung/liver border, misalignment artifacts due to gross voluntary motion, and quantification errors in cardiac PET imaging.
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Affiliation(s)
| | - Vijay Shah
- Siemens Medical Solutions USA, Inc., 810 Innovation Drive, Knoxville, TN, 37932, USA
| | - Charles Hayden
- Siemens Medical Solutions USA, Inc., 810 Innovation Drive, Knoxville, TN, 37932, USA
| | - John O Prior
- Department of Nuclear and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Sven Zuehlsdorff
- Siemens Medical Solutions USA, Inc., 810 Innovation Drive, Knoxville, TN, 37932, USA
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24
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Champendal M, Jreige M, Nicod Lalonde M, Pires Jorge JA, Matter M, Sykiotis GP, Prior JO. Feasibility and Performance of Free-Hand Single-Photon Computed Tomography/Ultrasonography for Preoperative Parathyroid Adenoma Localization: A Pilot Study. Diagnostics (Basel) 2023; 13:2200. [PMID: 37443593 DOI: 10.3390/diagnostics13132200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/11/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of this prospective pilot study was to evaluate the feasibility of a new hybrid imaging modality, free-hand single-photon computed tomography/ultrasonography (fhSPECT/US), for preoperative localization of parathyroid adenomas and to compare its performance with conventional ultrasonography and SPECT/CT. Twelve patients diagnosed with primary hyperparathyroidism underwent sequentially US and parathyroid scintigraphy, including SPECT/CT, followed by fhSPECT/US, allowing for real-time fusion between US and freehand-generated gamma-camera images. The fhSPECT/US detection rates were correlated with histopathology, when available, or with the imaging modality showing the most lesions. Based on a per patient analysis, the detection rate was significantly different when comparing SPECT/CT to fhSPECT/US (p = 0.03), and not significantly different when comparing SPECT/CT to US (p = 0.16) and US to fhSPECT/US (p = 0.08). Based on a per-lesion analysis, the detection rate of SPECT/CT was significantly higher than that of US (p = 0.01) and fhSEPCT/US (p = 0.003), and there was no significant difference in detection rate when comparing US to fhSPECT/US (p = 0.08). The main perceived limitations of fhSPECT/US in lesion detection were: (i) lesions localized at a depth ≥4.5 cm; (ii) imperfect image fusion due to tissue compression; (iii) limited spatial manipulation ability of the SPECT mobile camera handheld probe; and (iv) a wide spread of detected activity. In conclusion, clinical use of fhSPECT/US for localization of parathyroid adenomas is feasible, but shows lower sensitivity than conventional modalities and requires technical improvements.
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Affiliation(s)
- Mélanie Champendal
- School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, 1011 Lausanne, Switzerland
| | - Mario Jreige
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - José A Pires Jorge
- School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, 1011 Lausanne, Switzerland
| | - Maurice Matter
- Visceral Surgery Department, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - Gerasimos P Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland
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25
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Gnesin S, Chouin N, Cherel M, Dunn SM, Schaefer N, Faivre-Chauvet A, Prior JO, Delage JA. From bench to bedside: 64Cu/ 177Lu 1C1m-Fc anti TEM-1: mice-to-human dosimetry extrapolations for future theranostic applications. EJNMMI Res 2023; 13:59. [PMID: 37314509 DOI: 10.1186/s13550-023-01010-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023] Open
Abstract
The development of diagnostic and therapeutic radiopharmaceuticals is an hot topic in nuclear medicine. Several radiolabeled antibodies are under development necessitating both biokinetic and dosimetry extrapolations for effective human translation. The validation of different animal-to-human dosimetry extrapolation methods still is an open issue. This study reports the mice-to-human dosimetry extrapolation of 64Cu/177Lu 1C1m-Fc anti-TEM-1 for theranostic application in soft-tissue sarcomas. We adopt four methods; direct mice-to-human extrapolation (M1); dosimetry extrapolation considering a relative mass scaling factor (M2), application of a metabolic scaling factor (M3) and combination of M2 and M3 (M4). Predicted in-human dosimetry for the [64Cu]Cu-1C1m-Fc resulted in an effective dose of 0.05 mSv/MBq. Absorbed dose (AD) extrapolation for the [177Lu]Lu-1C1m-Fc indicated that the AD of 2 Gy and 4 Gy to the red-marrow and total-body can be reached with 5-10 GBq and 25-30 GBq of therapeutic activity administration respectively depending on applied dosimetry method. Dosimetry extrapolation methods provided significantly different absorbed doses in organs. Dosimetry properties for the [64Cu]Cu-1C1m-Fc are suitable for a diagnostic in-human use. The therapeutic application of [177Lu]Lu-1C1m-Fc presents challenges and would benefit from further assessments in animals' models such as dogs before moving into the clinic.
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Affiliation(s)
- Silvano Gnesin
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Nicolas Chouin
- Inserm, CNRS, University of Angers, Oniris, CRCI2NA, University of Nantes, Nantes, France
| | - Michel Cherel
- CHU Nantes, CNRS, Inserm, CRCINA, University of Nantes, 44000, Nantes, France
| | - Steven Mark Dunn
- LAbCore, Ludwig Institute for Cancer Research, Lausanne University Hospital and University of Lausanne, 1066, Epalinges, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | | | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| | - Judith Anna Delage
- Radiopharmacy Unit, Department of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
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Jreige M, Kurian GK, Perriraz J, Potheegadoo J, Bernasconi F, Stampacchia S, Blanke O, Alessandra G, Lejay N, Chiabotti PS, Rouaud O, Nicod Lalonde M, Schaefer N, Treglia G, Allali G, Prior JO. The diagnostic performance of functional dopaminergic scintigraphic imaging in the diagnosis of dementia with Lewy bodies: an updated systematic review. Eur J Nucl Med Mol Imaging 2023; 50:1988-2035. [PMID: 36920494 PMCID: PMC10199865 DOI: 10.1007/s00259-023-06154-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/13/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION Dopaminergic scintigraphic imaging is a cornerstone to support the diagnosis in dementia with Lewy bodies. To clarify the current state of knowledge on this imaging modality and its impact on clinical diagnosis, we performed an updated systematic review of the literature. METHODS This systematic review was carried out according to PRISMA guidelines. A comprehensive computer literature search of PubMed/MEDLINE, EMBASE, and Cochrane Library databases for studies published through June 2022 was performed using the following search algorithm: (a) "Lewy body" [TI] OR "Lewy bodies" [TI] and (b) ("DaTscan" OR "ioflupane" OR "123ip" OR "123?ip" OR "123 ip" OR "123i-FP-CIT" OR "FPCIT" OR "FP-CIT" OR "beta?CIT" OR "beta CIT" OR "CIT?SPECT" OR "CIT SPECT" OR "Dat?scan*" OR "dat scan*" OR "dat?spect*" OR "SPECT"). Risk of bias and applicability concerns of the studies were evaluated using the QUADAS-2 tool. RESULTS We performed a qualitative analysis of 59 studies. Of the 59 studies, 19 (32%) addressed the diagnostic performance of dopamine transporter imaging, 15 (25%) assessed the identification of dementia with Lewy bodies in the spectrum of Lewy body disease and 18 (31%) investigated the role of functional dopaminergic imaging in distinguishing dementia with Lewy bodies from other dementias. Dopamine transporter loss was correlated with clinical outcomes in 19 studies (32%) and with other functional imaging modalities in 15 studies (25%). Heterogeneous technical aspects were found among the studies through the use of various radioligands, the more prevalent being the [123I]N‑ω‑fluoropropyl‑2β‑carbomethoxy‑3β‑(4‑iodophenyl) nortropane (123I-FP-CIT) in 54 studies (91.5%). Image analysis used visual analysis (9 studies, 15%), semi-quantitative analysis (29 studies, 49%), or a combination of both (16 studies, 27%). CONCLUSION Our systematic review confirms the major role of dopaminergic scintigraphic imaging in the assessment of dementia with Lewy bodies. Early diagnosis could be facilitated by identifying the prodromes of dementia with Lewy bodies using dopaminergic scintigraphic imaging coupled with emphasis on clinical neuropsychiatric symptoms. Most published studies use a semi-quantitative analytical assessment of tracer uptake, while there are no studies using quantitative analytical methods to measure dopamine transporter loss. The superiority of a purely quantitative approach to assess dopaminergic transmission more accurately needs to be further clarified.
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Affiliation(s)
- Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - George K Kurian
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Jérémy Perriraz
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Jevita Potheegadoo
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Sara Stampacchia
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute & Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Griffa Alessandra
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Noemie Lejay
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Paolo Salvioni Chiabotti
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Rouaud
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Giorgio Treglia
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, 6900, Lugano, Switzerland
| | - Gilles Allali
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
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Gnesin S, Mikell JK, Conti M, Prior JO, Carlier T, Lima TVM, Dewaraja YK. A Multicenter Study on Observed Discrepancies Between Vendor-Stated and PET-Measured 90Y Activities for Both Glass and Resin Microsphere Devices. J Nucl Med 2023; 64:825-828. [PMID: 36418169 PMCID: PMC10152131 DOI: 10.2967/jnumed.122.264458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Dosimetry-guided treatment planning in selective internal radiation therapy relies on accurate and reproducible measurement of administered activity. This 4-center, 5-PET-device study compared the manufacturer-declared 90Y activity in vials with quantitative 90Y PET/CT assessment of the same vials. We compared 90Y PET-measured activity (APET) for 56 90Y-labeled glass and 18 90Y-labeled resin microsphere vials with the calibrated activity specified by the manufacturer (AM). Additionally, the same analysis was performed for 4 90Y-chloride vials. The mean APET/AM ratio was 0.79 ± 0.04 (range, 0.71-0.89) for glass microspheres and 1.15 ± 0.06 (range, 1.05-1.25) for resin microspheres. The mean APET/AM ratio for 90Y-chloride vials was 1.00 ± 0.04 (range, 0.96-1.06). Thus, we found an average difference of 46% between glass and resin microsphere activity calibrations, whereas close agreement was found for chloride solutions. We expect that the reported discrepancies will promote further investigations to establish reliable and accurate patient dosimetry and dose-effect assessments.
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Affiliation(s)
- Silvano Gnesin
- Institute of Radiation Physics, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Justin K Mikell
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, and Department of Radiation Oncology, Washington University, St. Louis, Missouri
| | - Maurizio Conti
- Department of Molecular Imaging, Siemens Medical Solutions, Knoxville, Tennessee
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland;
| | - Thomas Carlier
- Nuclear Medicine Department, University Hospital of Nantes, Nantes, France
| | - Thiago V M Lima
- Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Luzern, Switzerland; and
| | - Yuni K Dewaraja
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan
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28
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Abler D, Courlet P, Dietz M, Gatta R, Girard P, Munafo A, Wicky A, Jreige M, Guidi M, Latifyan S, De Micheli R, Csajka C, Prior JO, Michielin O, Terranova N, Cuendet MA. Semiautomated Pipeline to Quantify Tumor Evolution From Real-World Positron Emission Tomography/Computed Tomography Imaging. JCO Clin Cancer Inform 2023; 7:e2200126. [PMID: 37146261 PMCID: PMC10281365 DOI: 10.1200/cci.22.00126] [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: 08/19/2022] [Revised: 11/04/2022] [Accepted: 02/03/2023] [Indexed: 05/07/2023] Open
Abstract
PURPOSE A semiautomated pipeline for the collection and curation of free-text and imaging real-world data (RWD) was developed to quantify cancer treatment outcomes in large-scale retrospective real-world studies. The objectives of this article are to illustrate the challenges of RWD extraction, to demonstrate approaches for quality assurance, and to showcase the potential of RWD for precision oncology. METHODS We collected data from patients with advanced melanoma receiving immune checkpoint inhibitors at the Lausanne University Hospital. Cohort selection relied on semantically annotated electronic health records and was validated using process mining. The selected imaging examinations were segmented using an automatic commercial software prototype. A postprocessing algorithm enabled longitudinal lesion identification across imaging time points and consensus malignancy status prediction. Resulting data quality was evaluated against expert-annotated ground-truth and clinical outcomes obtained from radiology reports. RESULTS The cohort included 108 patients with melanoma and 465 imaging examinations (median, 3; range, 1-15 per patient). Process mining was used to assess clinical data quality and revealed the diversity of care pathways encountered in a real-world setting. Longitudinal postprocessing greatly improved the consistency of image-derived data compared with single time point segmentation results (classification precision increased from 53% to 86%). Image-derived progression-free survival resulting from postprocessing was comparable with the manually curated clinical reference (median survival of 286 v 336 days, P = .89). CONCLUSION We presented a general pipeline for the collection and curation of text- and image-based RWD, together with specific strategies to improve reliability. We showed that the resulting disease progression measures match reference clinical assessments at the cohort level, indicating that this strategy has the potential to unlock large amounts of actionable retrospective real-world evidence from clinical records.
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Affiliation(s)
- Daniel Abler
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Informatics, School of Management, University of Applied Sciences Western Switzerland (HES-SO), Sierre, Switzerland
| | - Perrine Courlet
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthieu Dietz
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
| | - Roberto Gatta
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pascal Girard
- Translational Medicine, Merck Institute of Pharmacometrics, Lausanne, Switzerland, an Affiliate of Merck KGaA, Darmstadt, Germany
| | - Alain Munafo
- Translational Medicine, Merck Institute of Pharmacometrics, Lausanne, Switzerland, an Affiliate of Merck KGaA, Darmstadt, Germany
| | - Alexandre Wicky
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mario Jreige
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Monia Guidi
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sofiya Latifyan
- Service of Medical Oncology, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Rita De Micheli
- Service of Medical Oncology, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Chantal Csajka
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - John O. Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Michielin
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nadia Terranova
- Translational Medicine, Merck Institute of Pharmacometrics, Lausanne, Switzerland, an Affiliate of Merck KGaA, Darmstadt, Germany
| | - Michel A. Cuendet
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Swiss Institute of Bioinformatics, University of Lausanne, Lausanne, Switzerland
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY
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29
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Corby-Zauner C, Monney P, Papadimitriou-Olivgeris M, Prior JO, Kamani CH. 18F-FDG-PET/CT as part of the diagnostic workup of native valve endocarditis: A case report. J Nucl Cardiol 2023; 30:823-825. [PMID: 34791620 PMCID: PMC10126069 DOI: 10.1007/s12350-021-02849-7] [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] [Received: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 10/19/2022]
Affiliation(s)
| | - Pierre Monney
- Department of Cardiology, Lausanne University Hospital CHUV, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | | | - John O Prior
- University of Lausanne, Lausanne, Switzerland.
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CHUV, Lausanne, Switzerland.
| | - Christel H Kamani
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CHUV, Lausanne, Switzerland
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30
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Schaefferkoetter J, Shah V, Hayden C, Prior JO, Zuehlsdorff S. Correction to: Deep learning for improving PET/CT attenuation correction by elastic registration of anatomical data. Eur J Nucl Med Mol Imaging 2023:10.1007/s00259-023-06199-z. [PMID: 36964404 DOI: 10.1007/s00259-023-06199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Affiliation(s)
| | - Vijay Shah
- Siemens Medical Solutions USA, Inc, 810 Innovation Drive, Knoxville, TN, 37932, USA
| | - Charles Hayden
- Siemens Medical Solutions USA, Inc, 810 Innovation Drive, Knoxville, TN, 37932, USA
| | - John O Prior
- Department of Nuclear and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Sven Zuehlsdorff
- Siemens Medical Solutions USA, Inc, 810 Innovation Drive, Knoxville, TN, 37932, USA
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31
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Abler D, Schaer R, Oreiller V, Verma H, Reichenbach J, Aidonopoulos O, Evéquoz F, Jreige M, Prior JO, Depeursinge A. QuantImage v2: a comprehensive and integrated physician-centered cloud platform for radiomics and machine learning research. Eur Radiol Exp 2023; 7:16. [PMID: 36947346 PMCID: PMC10033788 DOI: 10.1186/s41747-023-00326-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/23/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Radiomics, the field of image-based computational medical biomarker research, has experienced rapid growth over the past decade due to its potential to revolutionize the development of personalized decision support models. However, despite its research momentum and important advances toward methodological standardization, the translation of radiomics prediction models into clinical practice only progresses slowly. The lack of physicians leading the development of radiomics models and insufficient integration of radiomics tools in the clinical workflow contributes to this slow uptake. METHODS We propose a physician-centered vision of radiomics research and derive minimal functional requirements for radiomics research software to support this vision. Free-to-access radiomics tools and frameworks were reviewed to identify best practices and reveal the shortcomings of existing software solutions to optimally support physician-driven radiomics research in a clinical environment. RESULTS Support for user-friendly development and evaluation of radiomics prediction models via machine learning was found to be missing in most tools. QuantImage v2 (QI2) was designed and implemented to address these shortcomings. QI2 relies on well-established existing tools and open-source libraries to realize and concretely demonstrate the potential of a one-stop tool for physician-driven radiomics research. It provides web-based access to cohort management, feature extraction, and visualization and supports "no-code" development and evaluation of machine learning models against patient-specific outcome data. CONCLUSIONS QI2 fills a gap in the radiomics software landscape by enabling "no-code" radiomics research, including model validation, in a clinical environment. Further information about QI2, a public instance of the system, and its source code is available at https://medgift.github.io/quantimage-v2-info/ . Key points As domain experts, physicians play a key role in the development of radiomics models. Existing software solutions do not support physician-driven research optimally. QuantImage v2 implements a physician-centered vision for radiomics research. QuantImage v2 is a web-based, "no-code" radiomics research platform.
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Affiliation(s)
- Daniel Abler
- Institute of Informatics, School of Management, HES-SO Valais-Wallis, Sierre, Switzerland
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Roger Schaer
- Institute of Informatics, School of Management, HES-SO Valais-Wallis, Sierre, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Valentin Oreiller
- Institute of Informatics, School of Management, HES-SO Valais-Wallis, Sierre, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Himanshu Verma
- Knowledge and Intelligence Design Group, Delft University of Technology, Delft, The Netherlands
| | - Julien Reichenbach
- Institute of Informatics, School of Management, HES-SO Valais-Wallis, Sierre, Switzerland
| | - Orfeas Aidonopoulos
- Institute of Informatics, School of Management, HES-SO Valais-Wallis, Sierre, Switzerland
| | - Florian Evéquoz
- Institute of Informatics, School of Management, HES-SO Valais-Wallis, Sierre, Switzerland
| | - Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Adrien Depeursinge
- Institute of Informatics, School of Management, HES-SO Valais-Wallis, Sierre, Switzerland.
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Andrearczyk V, Oreiller V, Abobakr M, Akhavanallaf A, Balermpas P, Boughdad S, Capriotti L, Castelli J, Le Rest CC, Decazes P, Correia R, El-Habashy D, Elhalawani H, Fuller CD, Jreige M, Khamis Y, La Greca A, Mohamed A, Naser M, Prior JO, Ruan S, Tanadini-Lang S, Tankyevych O, Salimi Y, Vallières M, Vera P, Visvikis D, Wahid K, Zaidi H, Hatt M, Depeursinge A. Overview of the HECKTOR Challenge at MICCAI 2022: Automatic Head and Neck Tumor Segmentation and Outcome Prediction in PET/CT. Head Neck Tumor Chall (2022) 2023; 13626:1-30. [PMID: 37195050 PMCID: PMC10171217 DOI: 10.1007/978-3-031-27420-6_1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This paper presents an overview of the third edition of the HEad and neCK TumOR segmentation and outcome prediction (HECKTOR) challenge, organized as a satellite event of the 25th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) 2022. The challenge comprises two tasks related to the automatic analysis of FDG-PET/CT images for patients with Head and Neck cancer (H&N), focusing on the oropharynx region. Task 1 is the fully automatic segmentation of H&N primary Gross Tumor Volume (GTVp) and metastatic lymph nodes (GTVn) from FDG-PET/CT images. Task 2 is the fully automatic prediction of Recurrence-Free Survival (RFS) from the same FDG-PET/CT and clinical data. The data were collected from nine centers for a total of 883 cases consisting of FDG-PET/CT images and clinical information, split into 524 training and 359 test cases. The best methods obtained an aggregated Dice Similarity Coefficient (DSCagg) of 0.788 in Task 1, and a Concordance index (C-index) of 0.682 in Task 2.
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Affiliation(s)
- Vincent Andrearczyk
- Institute of Informatics, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
| | - Valentin Oreiller
- Institute of Informatics, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Moamen Abobakr
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | | | - Sarah Boughdad
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Leo Capriotti
- Center Henri Becquerel, LITIS Laboratory, University of Rouen Normandy, Rouen, France
| | - Joel Castelli
- Radiotherapy Department, Cancer Institute Eugène Marquis, Rennes, France
- INSERM, U1099, Rennes, France
- University of Rennes 1, LTSI, Rennes, France
| | - Catherine Cheze Le Rest
- Centre Hospitalier Universitaire de Poitiers (CHUP), Poitiers, France
- LaTIM, INSERM, UMR 1101, Univ Brest, Brest, France
| | - Pierre Decazes
- Center Henri Becquerel, LITIS Laboratory, University of Rouen Normandy, Rouen, France
| | - Ricardo Correia
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Dina El-Habashy
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Hesham Elhalawani
- Cleveland Clinic Foundation, Department of Radiation Oncology, Cleveland, OH, USA
| | | | - Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Yornna Khamis
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | | | - Mohamed Naser
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Su Ruan
- Center Henri Becquerel, LITIS Laboratory, University of Rouen Normandy, Rouen, France
| | | | - Olena Tankyevych
- Centre Hospitalier Universitaire de Poitiers (CHUP), Poitiers, France
- LaTIM, INSERM, UMR 1101, Univ Brest, Brest, France
| | | | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Pierre Vera
- Center Henri Becquerel, LITIS Laboratory, University of Rouen Normandy, Rouen, France
| | | | - Kareem Wahid
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Habib Zaidi
- Geneva University Hospital, Geneva, Switzerland
| | - Mathieu Hatt
- LaTIM, INSERM, UMR 1101, Univ Brest, Brest, France
| | - Adrien Depeursinge
- Institute of Informatics, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
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Dietz M, Dunet V, Mantziari S, Pomoni A, Dias Correia R, Testart Dardel N, Boughdad S, Nicod Lalonde M, Treglia G, Schafer M, Schaefer N, Prior JO. Comparison of integrin α vβ 3 expression with 68Ga-NODAGA-RGD PET/CT and glucose metabolism with 18F-FDG PET/CT in esophageal or gastroesophageal junction cancers. Eur J Hybrid Imaging 2023; 7:3. [PMID: 36720731 PMCID: PMC9889587 DOI: 10.1186/s41824-023-00162-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/09/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The primary aims of this study were to compare in patients with esophageal or esophagogastric junction cancers the potential of 68Ga-NODAGA-RGD PET/CT with that of 18F-FDG PET/CT regarding tumoral uptake and distribution, as well as histopathologic examination. METHODS Ten 68Ga-NODAGA-RGD and ten 18F-FDG PET/CT were performed in nine prospectively included participants (1 woman; aged 58 ± 8.4 y, range 40-69 y). Maximum SUV (SUVmax) and metabolic tumor volumes (MTV) were calculated. The Mann-Whitney U test and Spearman correlation analysis (ρ) were used. RESULTS 68Ga-NODAGA-RGD PET/CT detected positive uptake in 10 primary sites (8 for primary tumors and 2 for local relapse suspicion), 6 lymph nodes and 3 skeletal sites. 18F-FDG PET/CT detected positive uptake in the same sites but also in 16 additional lymph nodes and 1 adrenal gland. On a lesion-based analysis, SUVmax of 18F-FDG was significantly higher than those of 68Ga-NODAGA-RGD (4.9 [3.7-11.3] vs. 3.2 [2.6-4.2] g/mL, p = 0.014). Only one participant showed a higher SUVmax in an osseous metastasis with 68Ga-NODAGA-RGD as compared to 18F-FDG (6.6 vs. 3.9 g/mL). Correlation analysis showed positive correlation between 18F-FDG and 68Ga-NODAGA-RGD PET parameters (ρ = 0.56, p = 0.012 for SUVmax, ρ = 0.78, p < 0.001 for lesion-to-background ratios and ρ = 0.58, p = 0.024 for MTV). We observed that 18F-FDG uptake was homogenous inside all the confirmed primary sites (n = 9). In contrast, 68Ga-NODAGA-RGD PET showed more heterogenous uptake in 6 out of the 9 confirmed primary sites (67%), seen mostly in the periphery of the tumor in 5 out of the 9 confirmed primary sites (56%), and showed slight extensions into perilesional structures in 5 out of the 9 confirmed primary sites (56%). CONCLUSIONS In conclusion, 68Ga-NODAGA-RGD has lower potential in the detection of esophageal or esophagogastric junction malignancies compared to 18F-FDG. However, the results suggest that PET imaging of integrin αvβ3 expression may provide complementary information and could aid in tumor diversity and delineation. TRIAL REGISTRATION Trial registration: NCT02666547. Registered January 28, 2016-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02666547 .
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Affiliation(s)
- Matthieu Dietz
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland ,grid.25697.3f0000 0001 2172 4233INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
| | - Vincent Dunet
- grid.8515.90000 0001 0423 4662Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204University of Lausanne, Lausanne, Switzerland
| | - Styliani Mantziari
- grid.9851.50000 0001 2165 4204University of Lausanne, Lausanne, Switzerland ,grid.8515.90000 0001 0423 4662Department of Visceral Surgery, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Anastasia Pomoni
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Ricardo Dias Correia
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Nathalie Testart Dardel
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Sarah Boughdad
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Marie Nicod Lalonde
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204University of Lausanne, Lausanne, Switzerland
| | - Giorgio Treglia
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204University of Lausanne, Lausanne, Switzerland ,grid.469433.f0000 0004 0514 7845Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland ,grid.29078.340000 0001 2203 2861Università Della Svizzera Italiana, Lugano, Switzerland
| | - Markus Schafer
- grid.9851.50000 0001 2165 4204University of Lausanne, Lausanne, Switzerland ,grid.8515.90000 0001 0423 4662Department of Visceral Surgery, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Niklaus Schaefer
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204University of Lausanne, Lausanne, Switzerland
| | - John O. Prior
- grid.8515.90000 0001 0423 4662Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204University of Lausanne, Lausanne, Switzerland
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Graziani M, Dutkiewicz L, Calvaresi D, Amorim JP, Yordanova K, Vered M, Nair R, Abreu PH, Blanke T, Pulignano V, Prior JO, Lauwaert L, Reijers W, Depeursinge A, Andrearczyk V, Müller H. A global taxonomy of interpretable AI: unifying the terminology for the technical and social sciences. Artif Intell Rev 2023; 56:3473-3504. [PMID: 36092822 PMCID: PMC9446618 DOI: 10.1007/s10462-022-10256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Since its emergence in the 1960s, Artificial Intelligence (AI) has grown to conquer many technology products and their fields of application. Machine learning, as a major part of the current AI solutions, can learn from the data and through experience to reach high performance on various tasks. This growing success of AI algorithms has led to a need for interpretability to understand opaque models such as deep neural networks. Various requirements have been raised from different domains, together with numerous tools to debug, justify outcomes, and establish the safety, fairness and reliability of the models. This variety of tasks has led to inconsistencies in the terminology with, for instance, terms such as interpretable, explainable and transparent being often used interchangeably in methodology papers. These words, however, convey different meanings and are "weighted" differently across domains, for example in the technical and social sciences. In this paper, we propose an overarching terminology of interpretability of AI systems that can be referred to by the technical developers as much as by the social sciences community to pursue clarity and efficiency in the definition of regulations for ethical and reliable AI development. We show how our taxonomy and definition of interpretable AI differ from the ones in previous research and how they apply with high versatility to several domains and use cases, proposing a-highly needed-standard for the communication among interdisciplinary areas of AI.
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Affiliation(s)
- Mara Graziani
- University of Applied Sciences of Western Switzerland (HES-SO Valais), Rue du Technopole 3, Sierre, 3960 Valais Switzerland.,Department of Computer Science, University of Geneva (UniGe), Route de Drize 7, Carouge, 1227 Vaud Switzerland
| | - Lidia Dutkiewicz
- Centre for IT and IP Law, KU Leuven, Sint-Michielsstraat 6, Leuven, 3000 Belgium
| | - Davide Calvaresi
- University of Applied Sciences of Western Switzerland (HES-SO Valais), Rue du Technopole 3, Sierre, 3960 Valais Switzerland
| | - José Pereira Amorim
- CISUC, Department of Informatics Engineering, University of Coimbra, Pólo II, Pinhal de Marrocos, Coimbra, 3030-790 Portugal.,IPO-Porto Research Centre, Rua Dr. António Bernardino de Almeida, Porto, 4200-072 Portugal
| | - Katerina Yordanova
- Centre for IT and IP Law, KU Leuven, Sint-Michielsstraat 6, Leuven, 3000 Belgium
| | - Mor Vered
- Department of Data Science and AI, Monash University, Wellington Rd, Clayton VIC, Melbourne, 3800 Australia
| | - Rahul Nair
- IBM Research Europe, 3 Technology Campus, Dublin, D15 HN66 Ireland
| | - Pedro Henriques Abreu
- CISUC, Department of Informatics Engineering, University of Coimbra, Pólo II, Pinhal de Marrocos, Coimbra, 3030-790 Portugal
| | - Tobias Blanke
- Institute of Logic, Language and Computation, University of Amsterdam, Spui 21, Amsterdam, 1012WX Netherlands
| | - Valeria Pulignano
- Faculty of Social Science, Centre for Sociological Research, Parkstraat 45 bus, Leuven, 3000 Belgium
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, Lausanne, 1011 Vaud Switzerland
| | - Lode Lauwaert
- Institute of Philosophy, KU Leuven, Kardinaal Mercierplein 2, bus 3200, Leuven, 3000 Belgium
| | - Wessel Reijers
- Robert Schuman Centre, European University Institute, Via Boccaccio 121, Florence, 50133 Italy
| | - Adrien Depeursinge
- University of Applied Sciences of Western Switzerland (HES-SO Valais), Rue du Technopole 3, Sierre, 3960 Valais Switzerland.,Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, Lausanne, 1011 Vaud Switzerland
| | - Vincent Andrearczyk
- University of Applied Sciences of Western Switzerland (HES-SO Valais), Rue du Technopole 3, Sierre, 3960 Valais Switzerland
| | - Henning Müller
- University of Applied Sciences of Western Switzerland (HES-SO Valais), Rue du Technopole 3, Sierre, 3960 Valais Switzerland.,Department of Radiology and Medical Informatics, University of Geneva (UniGe), Rue Gabrielle-Perret-Gentil 4, Geneva, 1211 Vaud Switzerland
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Gautron Moura B, Gerard CL, Testart N, Caikovski M, Wicky A, Aedo-Lopez V, Berthod G, Homicsko K, Prior JO, Dromain C, Kandalaft LE, Cuendet MA, Michielin O. Estimated Costs of the Ipilimumab-Nivolumab Therapy and Related Adverse Events in Metastatic Melanoma. Cancers (Basel) 2022; 15:cancers15010031. [PMID: 36612030 PMCID: PMC9817856 DOI: 10.3390/cancers15010031] [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: 11/14/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Combined ipilimumab and nivolumab significantly improve outcomes in metastatic melanoma patients but bear an important financial impact on the healthcare system. Here, we analyze the treatment costs, focusing on irAE. We conducted a retrospective analysis of 62 melanoma patients treated with ipilimumab-nivolumab at the Lausanne University Hospital between 1 June 2016 and 31 August 2019. The frequency of irAEs and outcomes were evaluated. All melanoma-specific costs were analyzed from the first ipilimumab-nivolumab dose until the therapy given subsequently or death. A total of 54/62 (87%) patients presented at least one irAE, and 31/62 (50%) presented a grade 3-4 irAE. The majority of patients who had a complete response 12/14 (86%) and 21/28 (75%) of overall responders presented a grade 3-4 toxicity, and there were no responses in patients without toxicity. Toxicity costs represented only 3% of the total expenses per patient. The most significant contributions were medication costs (44%) and disease costs (39%), mainly disease-related hospitalization costs, not toxicity-related. Patients with a complete response had the lowest global median cost per week of follow up (EUR 2425) and patients who had progressive disease (PD), the highest one (EUR 8325). Except for one patient who had a Grade 5 toxicity (EUR 6043/week), we observe that less severe toxicity grades (EUR 9383/week for Grade 1), or even the absence of toxicity (EUR 9922/week), are associated with higher median costs per week (vs. EUR 3266/week for Grade 4 and EUR 2850/week for Grade 3). The cost of toxicities was unexpectedly low compared to the total costs, especially medication costs. Patients with higher toxicity grades had better outcomes and lower total costs due to treatment discontinuation.
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Affiliation(s)
- Bianca Gautron Moura
- Service of Oncology, Cantonal Hospital Fribourg (HFR), Chemin des Pensionnats 1-6, 1700 Fribourg, Switzerland
- Correspondence: (B.G.M.); (O.M.)
| | - Camille L. Gerard
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
| | - Nathalie Testart
- Department of Radiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Marian Caikovski
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
| | - Alexandre Wicky
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
| | - Veronica Aedo-Lopez
- Department of Oncology, Monash Medical Centre, 823-865 Centre Road, East Bentleigh, Melbourne, VIC 3165, Australia
| | - Grégoire Berthod
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
- Service of Oncology, Valais Hospital (CHVR), Avenue Grand Champsec 80, 1951 Sion, Switzerland
| | - Krisztian Homicsko
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
| | - John O. Prior
- Department of Radiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Clarisse Dromain
- Department of Radiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Lana E. Kandalaft
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
| | - Michel A. Cuendet
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
- Department of Physiology and Biophysics, Weill Cornell Medicine, 1300 York Av., New York, NY 10065, USA
- Swiss Institute of Bioinformatics, UNIL Sorge, 1015 Lausanne, Switzerland
| | - Olivier Michielin
- Department of Oncology, Lausanne University Hospital and Agora Translational Cancer Research Center, Rue du Bugnon, 1011 Lausanne, Switzerland
- Swiss Institute of Bioinformatics, UNIL Sorge, 1015 Lausanne, Switzerland
- Correspondence: (B.G.M.); (O.M.)
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Boughdad S, Da Mota M, Mendes De Carvalho M, Firsova M, Prior JO, Schaefer N. Lymphopenia during 177Lu-DOTATATE therapy leading to recurrence of tuberculosis: a case report. Eur J Hybrid Imaging 2022; 6:36. [PMID: 36510100 PMCID: PMC9744994 DOI: 10.1186/s41824-022-00157-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/14/2022] [Indexed: 12/14/2022] Open
Abstract
We report the case of a 72-year-old woman who presented with tuberculous arthritis during the setting of 177Lu-DOTATATE therapy for a grade-2 neuro-endocrine pancreatic tumor with liver metastases. We hypothesized that this recurrence might have been related to the occurrence of lymphopenia, which is common during PRRT. Indeed, though lymphopenia is frequently dismissed, it could lead to the development of opportunistic diseases and its severity should be examined, especially in case of abnormal clinical symptoms.
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Affiliation(s)
- Sarah Boughdad
- grid.8515.90000 0001 0423 4662Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Michael Da Mota
- grid.8515.90000 0001 0423 4662Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Mélanie Mendes De Carvalho
- grid.8515.90000 0001 0423 4662Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Maria Firsova
- grid.8515.90000 0001 0423 4662Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - John O. Prior
- grid.8515.90000 0001 0423 4662Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Niklaus Schaefer
- grid.8515.90000 0001 0423 4662Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
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Dedeciusova M, Prior JO, Schiappacasse L, Patin D, Levivier M, Tuleasca C. The role of single fraction Gamma Knife radiosurgery for intraventricular central neurocytomas and the utility of F-18 fluroethyltyrosine: two case reports. J Med Case Rep 2022; 16:441. [PMID: 36437467 PMCID: PMC9703805 DOI: 10.1186/s13256-022-03665-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 11/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Primary treatment of central neurocytomas is surgical resection. Gamma Knife surgery is considered a valuable therapeutic option in case of residual (after subtotal resection) or recurrent central neurocytomas. Here, we focused on the role of F-18 fluroethyltyrosine as a marker to document tumor progression after initial resection, in the context of an atypical central neurocytoma. We also describe MIB-1's role in evaluating therapeutic decision-making. CASE PRESENTATION Two patients with central neurocytomas were treated by Gamma Knife surgery in our center. The first case (31-year-old Caucasian male) had atypical central neurocytoma. Four and a half years after surgical resection, magnetic resonance imaging and F-18 fluroethyltyrosine documented clear progression of residual central neurocytoma, further treated by Gamma Knife surgery (18 Gy at 50%, target volume 1.4 cc, and prescription isodose volume 1.8 cc). The initial post-Gamma Knife surgery clinical course was uneventful, with progressive volumetric reduction of residual tumor up to 4.5 years, when out-of-field recurrence was suspected and confirmed by local F-18 fluroethyltyrosine hyperactivity. Second single-fraction Gamma Knife surgery was performed (18 Gy at 50%, target volume 0.49 cc, prescription isodose volume 0.72 cc). The second (32-year-old Caucasian female) had previous subtotal resection and typical central neurocytoma. Seven years later, she had residual tumor progression. Single-fraction Gamma Knife surgery was performed (16 Gy at 50% isodose line, target volume 1.7 cc, and prescription isodose volume 2.5 cc). Last follow-up showed tumor volume reduction. Follow-up magnetic resonance imaging showed important volumetric reduction of both treated lesions. CONCLUSIONS In atypical central neurocytomas, F-18 fluroethyltyrosine could be used as postoperative examination to detect small tumor remnants, follow-up evaluation following the Gamma Knife surgery or, in select cases, following surgical resection. The role of MIB-1 is important in therapeutic decision-making, as tumors with MIB-1 exceeding 2% are characterized by more aggressive clinical course. Single-fraction Gamma Knife surgery remains a valuable therapeutic option for postoperative residual atypical central neurocytomas and central neurocytoma recurrences.
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Affiliation(s)
- Michaela Dedeciusova
- University of Lausanne (Unil), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
- Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
- Department of Neurosurgery and Neurooncology, Military University Hospital Prague, Prague, Czech Republic
| | - John O Prior
- University of Lausanne (Unil), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
- Service of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Luis Schiappacasse
- Radiation Oncology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - David Patin
- Institute of Radiation Physics, Lausanne, Switzerland
| | - Marc Levivier
- University of Lausanne (Unil), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland
- Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Constantin Tuleasca
- University of Lausanne (Unil), Faculty of Biology and Medicine (FBM), Lausanne, Switzerland.
- Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
- Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
- Centre Hospitalier Universitaire Regional de Lille (Neurooncology and Epilepsy Fellow), Lille, France.
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Kathe C, Skinnider MA, Hutson TH, Regazzi N, Gautier M, Demesmaeker R, Komi S, Ceto S, James ND, Cho N, Baud L, Galan K, Matson KJE, Rowald A, Kim K, Wang R, Minassian K, Prior JO, Asboth L, Barraud Q, Lacour SP, Levine AJ, Wagner F, Bloch J, Squair JW, Courtine G. The neurons that restore walking after paralysis. Nature 2022; 611:540-547. [DOI: 10.1038/s41586-022-05385-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 09/23/2022] [Indexed: 11/10/2022]
Abstract
AbstractA spinal cord injury interrupts pathways from the brain and brainstem that project to the lumbar spinal cord, leading to paralysis. Here we show that spatiotemporal epidural electrical stimulation (EES) of the lumbar spinal cord1–3 applied during neurorehabilitation4,5 (EESREHAB) restored walking in nine individuals with chronic spinal cord injury. This recovery involved a reduction in neuronal activity in the lumbar spinal cord of humans during walking. We hypothesized that this unexpected reduction reflects activity-dependent selection of specific neuronal subpopulations that become essential for a patient to walk after spinal cord injury. To identify these putative neurons, we modelled the technological and therapeutic features underlying EESREHAB in mice. We applied single-nucleus RNA sequencing6–9 and spatial transcriptomics10,11 to the spinal cords of these mice to chart a spatially resolved molecular atlas of recovery from paralysis. We then employed cell type12,13 and spatial prioritization to identify the neurons involved in the recovery of walking. A single population of excitatory interneurons nested within intermediate laminae emerged. Although these neurons are not required for walking before spinal cord injury, we demonstrate that they are essential for the recovery of walking with EES following spinal cord injury. Augmenting the activity of these neurons phenocopied the recovery of walking enabled by EESREHAB, whereas ablating them prevented the recovery of walking that occurs spontaneously after moderate spinal cord injury. We thus identified a recovery-organizing neuronal subpopulation that is necessary and sufficient to regain walking after paralysis. Moreover, our methodology establishes a framework for using molecular cartography to identify the neurons that produce complex behaviours.
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Faist D, Jreige M, Oreiller V, Nicod Lalonde M, Schaefer N, Depeursinge A, Prior JO. Reproducibility of lung cancer radiomics features extracted from data-driven respiratory gating and free-breathing flow imaging in [ 18F]-FDG PET/CT. Eur J Hybrid Imaging 2022; 6:33. [PMID: 36309636 PMCID: PMC9617997 DOI: 10.1186/s41824-022-00153-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Quality and reproducibility of radiomics studies are essential requirements for the standardisation of radiomics models. As recent data-driven respiratory gating (DDG) [18F]-FDG has shown superior diagnostic performance in lung cancer, we evaluated the impact of DDG on the reproducibility of radiomics features derived from [18F]-FDG PET/CT in comparison to free-breathing flow (FB) imaging.
Methods Twenty four lung nodules from 20 patients were delineated. Radiomics features were derived on FB flow PET/CT and on the corresponding DDG reconstruction using the QuantImage v2 platform. Lin’s concordance factor (Cb) and the mean difference percentage (DIFF%) were calculated for each radiomics feature using the delineated nodules which were also classified by anatomical localisation and volume. Non-reproducible radiomics features were defined as having a bias correction factor Cb < 0.8 and/or a mean difference percentage DIFF% > 10.
Results In total 141 features were computed on each concordance analysis, 10 of which were non-reproducible on all pulmonary lesions. Those were first-order features from Laplacian of Gaussian (LoG)-filtered images (sigma = 1 mm): Energy, Kurtosis, Minimum, Range, Root Mean Squared, Skewness and Variance; Texture features from Gray Level Cooccurence Matrix (GLCM): Cluster Prominence and Difference Variance; First-order Standardised Uptake Value (SUV) feature: Kurtosis. Pulmonary lesions located in the superior lobes had only stable radiomics features, the ones from the lower parts had 25 non-reproducible radiomics features. Pulmonary lesions with a greater size (defined as long axis length > median) showed a higher reproducibility (9 non-reproducible features) than smaller ones (20 non-reproducible features).
Conclusion Calculated on all pulmonary lesions, 131 out of 141 radiomics features can be used interchangeably between DDG and FB PET/CT acquisitions. Radiomics features derived from pulmonary lesions located inferior to the superior lobes are subject to greater variability as well as pulmonary lesions of smaller size. Supplementary Information The online version contains supplementary material available at 10.1186/s41824-022-00153-2.
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Affiliation(s)
- Daphné Faist
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland
| | - Valentin Oreiller
- Institute of Information Systems, University of Applied Sciences Western Switzerland, (HES-SO), Rue du Technopôle 3, CH-3960, Sierre, Switzerland
| | - Marie Nicod Lalonde
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland
| | - Adrien Depeursinge
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.,Institute of Information Systems, University of Applied Sciences Western Switzerland, (HES-SO), Rue du Technopôle 3, CH-3960, Sierre, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland. .,Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, CH-1011, Lausanne, Switzerland.
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Stora T, Prior JO, Decristoforo C. Editorial: MEDICIS-promed: Advances in radioactive ion beams for nuclear medicine. Front Med (Lausanne) 2022; 9:1013619. [PMID: 36262271 PMCID: PMC9574352 DOI: 10.3389/fmed.2022.1013619] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Thierry Stora
- European Organization for Nuclear Research (CERN), Geneva, Switzerland
| | - John O. Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland,*Correspondence: John O. Prior
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
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Nesterov SV, Sciagrà R, Orozco LEJ, Prior JO, Settimo L, Han C, Deshayes E, deKemp RA, Ryzhkova DV, Gwet KL, Knuuti JM. One-tissue compartment model for myocardial perfusion quantification with N-13 ammonia PET provides matching results: A cross-comparison between Carimas, FlowQuant, and PMOD. J Nucl Cardiol 2022; 29:2543-2550. [PMID: 34409572 PMCID: PMC9553813 DOI: 10.1007/s12350-021-02741-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/26/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To cross-compare three software packages (SPs)-Carimas, FlowQuant, and PMOD-to quantify myocardial perfusion at global, regional, and segmental levels. MATERIALS AND METHODS Stress N-13 ammonia PET scans of 48 patients with HCM were analyzed in three centers using Carimas, FlowQuant, and PMOD. Values agreed if they had an ICC > 0.75 and a difference < 20% of the median across all observers. RESULTS When using 1TCM on the global level, the agreement was good, and the maximum difference between 1TCM MBF values was 17.2% (ICC = 0.83). On the regional level, the agreement was acceptable except in the LCx region (25.5% difference, ICC = 0.74) between FlowQuant and PMOD. Carimas-1TCM agreed well with PMOD-1TCM and FlowQuant-1TCM. Values obtained with FlowQuant-1TCM had a somewhat lesser agreement with PMOD-1TCM, especially at the segmental level. CONCLUSIONS The global and regional MBF values (with one exception) agree well between the different software packages. There is significant variability in segmental values, mainly located in the LCx region and segments. Out of the studied tools, Carimas can be used interchangeably with both PMOD and FlowQuant for 1TCM implementation on all levels-global, regional, and segmental.
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Affiliation(s)
- Sergey V Nesterov
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
- IM Sechenov Institute of Evolutionary Physiology and Biochemistry RAS, St. Petersburg, Russia.
| | | | | | | | | | - Chunlei Han
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Emmanuel Deshayes
- University of Lausanne, Lausanne, Switzerland
- Regional Cancer Institute of Montpellier (ICM) - Val d'Aurelle, Montpellier, France
| | - Robert A deKemp
- National Cardiac PET Center, University of Ottawa Heart Institute, Ottawa, Canada
| | - Darja V Ryzhkova
- Almazov Federal Heart, Blood and Endocrinology Centre, St. Petersburg, Russia
| | | | - Juhani M Knuuti
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
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Tonellotto L, Do Rosario Teixeira ARR, Iselin C, Kamani CH, Natacha D, Guenova E, Prior JO. Adult T-cell leukemia-lymphoma (ATLL) with initial cutaneous manifestation and lymphatic drainage. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00638-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Andrearczyk V, Oreiller V, Jreige M, Castelli J, Prior JO, Depeursinge A. Segmentation and Classification of Head and Neck Nodal Metastases and Primary Tumors in PET/CT. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:4731-4735. [PMID: 36086273 DOI: 10.1109/embc48229.2022.9871907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The prediction of cancer characteristics, treatment planning and patient outcome from medical images generally requires tumor delineation. In Head and Neck cancer (H&N), the automatic segmentation and differentiation of primary Gross Tumor Volumes (GTVt) and malignant lymph nodes (GTVn) is a necessary step for large-scale radiomics studies to predict patient outcome such as Progression Free Survival (PFS). Detecting malignant lymph nodes is also a crucial step for Tumor-Node-Metastases (TNM) staging and to support the decision to resect the nodes. In turn, automatic TNM staging and patient outcome prediction can greatly benefit patient care by helping clinicians to find the best personalized treatment. We propose the first model to automatically individually segment GTVt and GTVn in PET/CT images. A bi-modal 3D U-Net model is trained for multi-class and multi-components segmentation on the multi-centric HECKTOR 2020 dataset containing 254 cases. The dataset has been specifically re-annotated by experts to obtain ground truth GTVn contours. The results show promising segmentation performance for the automation of radiomics pipelines and their validation on large-scale studies for which manual annotations are not available. An average test Dice Similarity Coefficients (DSC) of 0.717 is obtained for the segmentation of GTVt. The GTVn segmentation is evaluated with an aggregated DSC to account for the cases without GTVn, which is estimated at 0.729 on the test set.
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Darçot E, Jreige M, Rotzinger DC, Gidoin Tuyet Van S, Casutt A, Delacoste J, Simons J, Long O, Buela F, Ledoux JB, Prior JO, Lovis A, Beigelman-Aubry C. Comparison Between Magnetic Resonance Imaging and Computed Tomography in the Detection and Volumetric Assessment of Lung Nodules: A Prospective Study. Front Med (Lausanne) 2022; 9:858731. [PMID: 35573012 PMCID: PMC9096346 DOI: 10.3389/fmed.2022.858731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/25/2022] [Indexed: 11/22/2022] Open
Abstract
Rationale and Objectives Computed tomography (CT) lung nodule assessment is routinely performed and appears very promising for lung cancer screening. However, the radiation exposure through time remains a concern. With the overall goal of an optimal management of indeterminate lung nodules, the objective of this prospective study was therefore to evaluate the potential of optimized ultra-short echo time (UTE) MRI for lung nodule detection and volumetric assessment. Materials and Methods Eight (54.9 ± 13.2 years) patients with at least 1 non-calcified nodule ≥4 mm were included. UTE under high-frequency non-invasive ventilation (UTE-HF-NIV) and in free-breathing at tidal volume (UTE-FB) were investigated along with volumetric interpolated breath-hold examination at full inspiration (VIBE-BH). Three experienced readers assessed the detection rate of nodules ≥4 mm and ≥6 mm, and reported their location, 2D-measurements and solid/subsolid nature. Volumes were measured by two experienced readers. Subsequently, two readers assessed the detection and volume measurements of lung nodules ≥4mm in gold-standard CT images with soft and lung kernel reconstructions. Volumetry was performed with lesion management software (Carestream, Rochester, New York, USA). Results UTE-HF-NIV provided the highest detection rate for nodules ≥4 mm (n = 66) and ≥6 mm (n = 32) (35 and 50%, respectively). No dependencies were found between nodule detection and their location in the lung with UTE-HF-NIV (p > 0.4), such a dependency was observed for two readers with VIBE-BH (p = 0.002 and 0.03). Dependencies between the nodule's detection and their size were noticed among readers and techniques (p < 0.02). When comparing nodule volume measurements, an excellent concordance was observed between CT and UTE-HF-NIV, with an overestimation of 13.2% by UTE-HF-NIV, <25%-threshold used for nodule's growth, conversely to VIBE-BH that overestimated the nodule volume by 28.8%. Conclusion UTE-HF-NIV is not ready to replace low-dose CT for lung nodule detection, but could be used for follow-up studies, alternating with CT, based on its volumetric accuracy.
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Affiliation(s)
- Emeline Darçot
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - David C Rotzinger
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Stacey Gidoin Tuyet Van
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Alessio Casutt
- Department of Pulmonology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jean Delacoste
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Julien Simons
- Department of Physiotherapy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Olivier Long
- Department of Physiotherapy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Flore Buela
- Department of Physiotherapy, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jean-Baptiste Ledoux
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - John O Prior
- Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland.,Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Alban Lovis
- Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland.,Department of Pulmonology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Catherine Beigelman-Aubry
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
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Dietz M, Kamani CH, Dunet V, Fournier S, Rubimbura V, Testart Dardel N, Schaefer A, Jreige M, Boughdad S, Nicod Lalonde M, Schaefer N, Mewton N, Prior JO, Treglia G. Overview of the RGD-Based PET Agents Use in Patients With Cardiovascular Diseases: A Systematic Review. Front Med (Lausanne) 2022; 9:887508. [PMID: 35602497 PMCID: PMC9120643 DOI: 10.3389/fmed.2022.887508] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/19/2022] [Indexed: 01/02/2023] Open
Abstract
Studies using arginine–glycine–aspartate (RGD)-PET agents in cardiovascular diseases have been recently published. The aim of this systematic review was to perform an updated, evidence-based summary about the role of RGD-based PET agents in patients with cardiovascular diseases to better address future research in this setting. Original articles within the field of interest reporting the role of RGD-based PET agents in patients with cardiovascular diseases were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until October 26, 2021. Literature shows an increasing role of RGD-based PET agents in patients with cardiovascular diseases. Overall, two main topics emerged: the infarcted myocardium and atherosclerosis. The existing studies support that αvβ3 integrin expression in the infarcted myocardium is well evident in RGD PET/CT scans. RGD-based PET radiotracers accumulate at the site of infarction as early as 3 days and seem to be peaking at 1–3 weeks post myocardial infarction before decreasing, but only 1 study assessed serial changes of myocardial RGD-based PET uptake after ischemic events. RGD-based PET uptake in large vessels showed correlation with CT plaque burden, and increased signal was found in patients with prior cardiovascular events. In human atherosclerotic carotid plaques, increased PET signal was observed in stenotic compared with non-stenotic areas based on MR or CT angiography data. Histopathological analysis found a co-localization between tracer accumulation and areas of αvβ3 expression. Promising applications using RGD-based PET agents are emerging, such as prediction of remodeling processes in the infarcted myocardium or detection of active atherosclerosis, with potentially significant clinical impact.
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Affiliation(s)
- Matthieu Dietz
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
| | - Christel H. Kamani
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Stephane Fournier
- Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Vladimir Rubimbura
- Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Nathalie Testart Dardel
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Ana Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Mario Jreige
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Sarah Boughdad
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Nathan Mewton
- INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
- Cardiovascular Hospital Louis Pradel, Department of Heart Failure, Hospices Civils de Lyon, Lyon, France
- Clinical Investigation Center Inserm 1407, Lyon, France
| | - John O. Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
- *Correspondence: John O. Prior
| | - Giorgio Treglia
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Università della Svizzera Italiana, Lugano, Switzerland
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Cicone F, Viertl D, Denoël T, Stabin MG, Prior JO, Gnesin S. Comparison of absorbed dose extrapolation methods for mouse-to-human translation of radiolabelled macromolecules. EJNMMI Res 2022; 12:21. [PMID: 35403982 PMCID: PMC9001797 DOI: 10.1186/s13550-022-00893-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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Extrapolation of human absorbed doses (ADs) from biodistribution experiments on laboratory animals is used to predict the efficacy and toxicity profiles of new radiopharmaceuticals. Comparative studies between available animal-to-human dosimetry extrapolation methods are missing. We compared five computational methods for mice-to-human AD extrapolations, using two different radiopharmaceuticals, namely [111In]CHX-DTPA-scFv78-Fc and [68Ga]NODAGA-RGDyK. Human organ-specific time-integrated activity coefficients (TIACs) were derived from biodistribution studies previously conducted in our centre. The five computational methods adopted are based on simple direct application of mice TIACs to human organs (M1), relative mass scaling (M2), metabolic time scaling (M3), combined mass and time scaling (M4), and organ-specific allometric scaling (M5), respectively. For [68Ga]NODAGA-RGDyK, these methods for mice-to-human extrapolations were tested against the ADs obtained on patients, previously published by our group. Lastly, an average [68Ga]NODAGA-RGDyK-specific allometric parameter αnew was calculated from the organ-specific biological half-lives in mouse and humans and retrospectively applied to M3 and M4 to assess differences in human AD predictions with the α = 0.25 recommended by previous studies. Results For both radiopharmaceuticals, the five extrapolation methods showed significantly different AD results (p < 0.0001). In general, organ ADs obtained with M3 were higher than those obtained with the other methods. For [68Ga]NODAGA-RGDyK, no significant differences were found between ADs calculated with M3 and those obtained directly on human subjects (H) (p = 0.99; average M3/H AD ratio = 1.03). All other methods for dose extrapolations resulted in ADs significantly different from those calculated directly on humans (all p ≤ 0.0001). Organ-specific allometric parameters calculated using combined experimental [68Ga]NODAGA-RGDyK mice and human biodistribution data varied significantly. ADs calculated with M3 and M4 after the application of αnew = 0.17 were significantly different from those obtained by the application of α = 0.25 (both p < 0.001). Conclusions Available methods for mouse-to-human dosimetry extrapolations provided significantly different results in two different experimental models. For [68Ga]NODAGA-RGDyK, the best approximation of human dosimetry was shown by M3, applying a metabolic scaling to the mouse organ TIACs. The accuracy of more refined extrapolation algorithms adopting model-specific metabolic scaling parameters should be further investigated. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-022-00893-z.
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Affiliation(s)
- Francesco Cicone
- Department of Experimental and Clinical Medicine, and Neuroscience Research Centre, PET/MR Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.,Nuclear Medicine Unit, University Hospital "Mater Domini", Catanzaro, Italy.,University of Lausanne, Lausanne, Switzerland
| | - David Viertl
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Thibaut Denoël
- Department of Experimental and Clinical Medicine, and Neuroscience Research Centre, PET/MR Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.,Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | | | - John O Prior
- University of Lausanne, Lausanne, Switzerland. .,Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| | - Silvano Gnesin
- University of Lausanne, Lausanne, Switzerland.,Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland
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Postupalenko V, Marx L, Viertl D, Gsponer N, Gasilova N, Denoel T, Schaefer N, Prior JO, Hagens G, Lévy F, Garrouste P, Segura JM, Nyanguile O. Template directed synthesis of antibody Fc conjugates with concomitant ligand release. Chem Sci 2022; 13:3965-3976. [PMID: 35440989 PMCID: PMC8985508 DOI: 10.1039/d1sc06182h] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/16/2022] [Indexed: 11/29/2022] Open
Abstract
Antibodies are an attractive therapeutic modality for cancer treatment as they allow the increase of the treatment response rate and avoid the severe side effects of chemotherapy. Notwithstanding the strong benefit of antibodies, the efficacy of anti-cancer antibodies can dramatically vary among patients and ultimately result in no response to the treatment. Here, we have developed a novel means to regioselectively label the Fc domain of any therapeutic antibody with a radionuclide chelator in a single step chemistry, with the aim to study by SPECT/CT imaging if the radiolabeled antibody is capable of targeting cancer cells in vivo. A Fc-III peptide was used as bait to bring a carbonate electrophilic site linked to a metal chelator and to a carboxyphenyl leaving group in close proximity with an antibody Fc nucleophile amino acid (K317), thereby triggering the covalent linkage of the chelator to the antibody lysine, with the concomitant release of the carboxyphenyl Fc-III ligand. Using CHX-A′′-DTPA, we radiolabeled trastuzumab with indium-111 and showed in biodistribution and imaging experiments that the antibody accumulated successfully in the SK-OV-3 xenograft tumour implanted in mice. We found that our methodology leads to homogeneous conjugation of CHX-A′′-DTPA to the antibody, and confirmed that the Fc domain can be selectively labeled at K317, with a minor level of unspecific labeling on the Fab domain. The present method can be developed as a clinical diagnostic tool to predict the success of the therapy. Furthermore, our Fc-III one step chemistry concept paves the way to a broad array of other applications in antibody bioengineering. A method is reported to attach a radionuclide chelator in a single step chemistry to the Fc domain of any therapeutic antibody.![]()
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Affiliation(s)
- Viktoriia Postupalenko
- Institute of Life Technologies, HES-SO Valais-Wallis Rue de l'Industrie 23 CH-1950 Sion Switzerland
| | - Léo Marx
- Debiopharm Research & Manufacturing SA, Campus "après-demain" Rue du Levant 146 1920 Martigny Switzerland
| | - David Viertl
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CH-1011 Lausanne Switzerland.,In Vivo Imaging Facility, Department of Research and Training, University of Lausanne CH-1011 Lausanne Switzerland
| | - Nadège Gsponer
- Institute of Life Technologies, HES-SO Valais-Wallis Rue de l'Industrie 23 CH-1950 Sion Switzerland
| | - Natalia Gasilova
- EPFL Valais Wallis, MSEAP, ISIC-GE-VS rue de l'Industrie 17 1951 Sion Switzerland
| | - Thibaut Denoel
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CH-1011 Lausanne Switzerland
| | - Niklaus Schaefer
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CH-1011 Lausanne Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital CH-1011 Lausanne Switzerland
| | - Gerrit Hagens
- Institute of Life Technologies, HES-SO Valais-Wallis Rue de l'Industrie 23 CH-1950 Sion Switzerland
| | - Frédéric Lévy
- Debiopharm International SA, Forum "après-demain" Chemin Messidor 5-7 Case postale 5911 1002 Lausanne Switzerland
| | - Patrick Garrouste
- Debiopharm Research & Manufacturing SA, Campus "après-demain" Rue du Levant 146 1920 Martigny Switzerland
| | - Jean-Manuel Segura
- Institute of Life Technologies, HES-SO Valais-Wallis Rue de l'Industrie 23 CH-1950 Sion Switzerland
| | - Origène Nyanguile
- Institute of Life Technologies, HES-SO Valais-Wallis Rue de l'Industrie 23 CH-1950 Sion Switzerland
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Nesterov SV, Deshayes E, Juarez-Orozco LE, deKemp RA, Sciagrà R, Malaspina S, Settimo L, Han C, Ryzhkova DV, Kostina IS, Gwet KL, Prior JO, Knuuti JM. Myocardial perfusion quantification with Rb-82 PET: good interobserver agreement of Carimas software on global, regional, and segmental levels. Ann Nucl Med 2022; 36:507-514. [PMID: 35192160 PMCID: PMC9132838 DOI: 10.1007/s12149-022-01729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/09/2022] [Indexed: 12/04/2022]
Abstract
Purpose To estimate the interobserver agreement of the Carimas software package (SP) on global, regional, and segmental levels for the most widely used myocardial perfusion PET tracer—Rb-82. Materials and methods Rest and stress Rb-82 PET scans of 48 patients with suspected or known coronary artery disease (CAD) were analyzed in four centers using the Carimas SP. We considered values to agree if they simultaneously had an intraclass correlation coefficient (ICC) > 0.75 and a difference < 20% of the median across all observers. Results The median values on the segmental level were 1.08 mL/min/g for rest myocardial blood flow (MBF), 2.24 mL/min/g for stress MBF, and 2.17 for myocardial flow reserve (MFR). For the rest MBF and MFR, all the values at all the levels fulfilled were in excellent agreement. For stress MBF, at the global and regional levels, all the 24 comparisons showed excellent agreement. Only 1 out of 102 segmental comparisons (seg. 14) was over the adequate agreement limit—23.5% of the median value (ICC = 0.95). Conclusion Interobserver agreement for Rb-82 PET myocardial perfusion quantification analyzed with Carimas is good at any LV segmentation level—global, regional, and segmental. It is good for all the estimates—rest MBF, stress MBF, and MFR.
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Affiliation(s)
- Sergey V Nesterov
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland. .,IM Sechenov Institute of Evolutionary Physiology and Biochemistry RAS, Saint Petersburg, Russia.
| | - Emmanuel Deshayes
- University of Lausanne, Lausanne, Switzerland.,Regional Cancer Institute of Montpellier (ICM)-Val d'Aurelle, Montpellier, France
| | | | - Robert A deKemp
- National Cardiac PET Center, University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Simona Malaspina
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Chunlei Han
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Darja V Ryzhkova
- Almazov Federal Heart, Blood and Endocrinology Centre, Saint Petersburg, Russia
| | - Irina S Kostina
- Almazov Federal Heart, Blood and Endocrinology Centre, Saint Petersburg, Russia
| | | | | | - Juhani M Knuuti
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
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Fontaine P, Andrearczyk V, Oreiller V, Abler D, Castelli J, Acosta O, De Crevoisier R, Vallières M, Jreige M, Prior JO, Depeursinge A. Cleaning Radiotherapy Contours for Radiomics Studies, is it Worth it? A Head and Neck Cancer Study. Clin Transl Radiat Oncol 2022; 33:153-158. [PMID: 35243026 PMCID: PMC8881196 DOI: 10.1016/j.ctro.2022.01.003] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 12/24/2022] Open
Abstract
PET images features are more stable across different delineation of the same target. Shape family features are more stable. The survival model based on Dedicated contours achieved better performance for predicting PFS.
A vast majority of studies in the radiomics field are based on contours originating from radiotherapy planning. This kind of delineation (e.g. Gross Tumor Volume, GTV) is often larger than the true tumoral volume, sometimes including parts of other organs (e.g. trachea in Head and Neck, H&N studies) and the impact of such over-segmentation was little investigated so far. In this paper, we propose to evaluate and compare the performance between models using two contour types: those from radiotherapy planning, and those specifically delineated for radiomics studies. For the latter, we modified the radiotherapy contours to fit the true tumoral volume. The two contour types were compared when predicting Progression-Free Survival (PFS) using Cox models based on radiomics features extracted from FluoroDeoxyGlucose-Positron Emission Tomography (FDG-PET) and CT images of 239 patients with oropharyngeal H&N cancer collected from five centers, the data from the 2020 HECKTOR challenge. Using Dedicated contours demonstrated better performance for predicting PFS, where Harell’s concordance indices of 0.61 and 0.69 were achieved for Radiotherapy and Dedicated contours, respectively. Using automatically Resegmented contours based on a fixed intensity range was associated with a C-index of 0.63. These results illustrate the importance of using clean dedicated contours that are close to the true tumoral volume in radiomics studies, even when tumor contours are already available from radiotherapy treatment planning
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Affiliation(s)
- Pierre Fontaine
- Univ Rennes, CLCC Eugene Marquis, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
- Institute of Information Systems, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
| | - Vincent Andrearczyk
- Institute of Information Systems, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
| | - Valentin Oreiller
- Institute of Information Systems, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Daniel Abler
- Institute of Information Systems, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Joel Castelli
- Univ Rennes, CLCC Eugene Marquis, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Oscar Acosta
- Univ Rennes, CLCC Eugene Marquis, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Renaud De Crevoisier
- Univ Rennes, CLCC Eugene Marquis, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Martin Vallières
- Department of Computer Science, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mario Jreige
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Adrien Depeursinge
- Institute of Information Systems, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Tian M, Civelek AC, Carrio I, Watanabe Y, Kang KW, Murakami K, Garibotto V, Prior JO, Barthel H, Zhou R, Hou H, Dou X, Jin C, Zuo C, Zhang H. International consensus on the use of tau PET imaging agent 18F-flortaucipir in Alzheimer's disease. Eur J Nucl Med Mol Imaging 2022; 49:895-904. [PMID: 34978595 PMCID: PMC8803772 DOI: 10.1007/s00259-021-05673-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 11/26/2021] [Accepted: 12/24/2021] [Indexed: 12/21/2022]
Abstract
Purpose Positron emission tomography (PET) with the first and only tau targeting radiotracer of 18F-flortaucipir approved by FDA has been increasingly used in depicting tau pathology deposition and distribution in patients with cognitive impairment. The goal of this international consensus is to help nuclear medicine practitioners procedurally perform 18F-flortaucipir PET imaging. Method A multidisciplinary task group formed by experts from various countries discussed and approved the consensus for 18F-flortaucipir PET imaging in Alzheimer’s disease (AD), focusing on clinical scenarios, patient preparation, and administered activities, as well as image acquisition, processing, interpretation, and reporting. Conclusion This international consensus and practice guideline will help to promote the standardized use of 18F-flortaucipir PET in patients with AD. It will become an international standard for this purpose in clinical practice.
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Affiliation(s)
- Mei Tian
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China. .,Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. .,Human Phenome Institute, Fudan University, Shanghai, 201203, China.
| | - A Cahid Civelek
- Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, MD, 21287, USA.
| | - Ignasi Carrio
- Department of Nuclear Medicine, Hospital Sant Pau, Autonomous University of Barcelona, 08025, Barcelona, Spain
| | - Yasuyoshi Watanabe
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, 650-0047, Japan
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Koji Murakami
- Department of Radiology, Juntendo University Hospital, Tokyo, 113-8431, Japan
| | - Valentina Garibotto
- Diagnostic Department, University Hospitals of Geneva and NIMTlab, University of Geneva, Geneva, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Rui Zhou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Haifeng Hou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Xiaofeng Dou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Chentao Jin
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China.,National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. .,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, China. .,The College of Biomedical Engineering and Instrument Science of Zhejiang University, Hangzhou, 310007, China. .,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310007, China.
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