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Verrecchia-Ramos E, Morel O, Ginet M, Retif P, Ben Mahmoud S. Clinical validation of an AI-based automatic quantification tool for lung lobes in SPECT/CT. EJNMMI Phys 2023; 10:57. [PMID: 37733103 PMCID: PMC10513978 DOI: 10.1186/s40658-023-00578-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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Lung lobar ventilation and perfusion (V/Q) quantification is generally obtained by generating planar scintigraphy images and then imposing three equally sized regions of interest on the data of each lung. This method is fast but not as accurate as SPECT/CT imaging, which provides three-dimensional data and therefore allows more precise lobar quantification. However, the manual delineation of each lobe is time-consuming, which makes SPECT/CT incompatible with the clinical workflow for V/Q estimation. An alternative may be to use artificial intelligence-based auto-segmentation tools such as AutoLung3D (Siemens Healthineers, Knoxville, USA), which automatically delineate the lung lobes on the CT data acquired with the SPECT data. The present study assessed the clinical validity of this approach relative to planar scintigraphy and manual quantification in SPECT/CT. METHODS The Autolung3D software was tested on the retrospective SPECT/CT data of 43 patients who underwent V/Q scintigraphy with 99mTc-macroaggregated albumin and 99mTc-labeled aerosol. It was compared to planar scintigraphy and SPECT/CT using the manual quantification method in terms of relative lobar V/Q quantification values and interobserver variability. RESULTS The three methods provided similar V/Q estimates for the left lung lobes and total lungs. However, compared to the manual SPECT/CT method, planar scintigraphy yielded significantly higher estimates for the middle right lobe and significantly lower estimates for the superior and inferior right lobes. The estimates of the manual and automated SPECT/CT methods were similar. However, the post-processing time in the automated method was approximately 5 min compared to 2 h for the manual method. Moreover, the automated method associated with a drastic reduction in interobserver variability: Its maximal relative standard deviation was only 5%, compared to 23% for planar scintigraphy and 19% for the manual SPECT/CT method. CONCLUSIONS This study validated the AutoLung3D software for general clinical use since it rapidly provides accurate lobar quantification in V/Q scans with markedly less interobserver variability than planar scintigraphy or the manual SPECT/CT method.
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Affiliation(s)
- Emilie Verrecchia-Ramos
- Department of Medical Physics, Mercy Hospital, CHR Metz-Thionville, 1, Allée du Château, 57530, Ars-Laquenexy, France.
| | - Olivier Morel
- Department of Nuclear Medicine, Mercy Hospital, CHR Metz-Thionville, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Merwan Ginet
- Department of Nuclear Medicine, Mercy Hospital, CHR Metz-Thionville, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Paul Retif
- Department of Medical Physics, Mercy Hospital, CHR Metz-Thionville, 1, Allée du Château, 57530, Ars-Laquenexy, France
- CNRS, CRAN, Université de Lorraine, 54000, Nancy, France
| | - Sinan Ben Mahmoud
- Department of Nuclear Medicine, Mercy Hospital, CHR Metz-Thionville, 1, Allée du Château, 57530, Ars-Laquenexy, France
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Oprea-Lager DE, Gontier E, García-Cañamaque L, Gauthé M, Olivier P, Mitjavila M, Tamayo P, Robin P, García Vicente AM, Bouyeure AC, Bailliez A, Rodríguez-Fernández A, Mahmoud SB, Vallejo-Casas JA, Maksud P, Merlin C, Blanc-Durand P, Drouet C, Tissot H, Vierasu I, Vander Borght T, Boos E, Chossat F, Hodolic M, Rousseau C. [ 18F]DCFPyL PET/CT versus [ 18F]fluoromethylcholine PET/CT in Biochemical Recurrence of Prostate Cancer (PYTHON): a prospective, open label, cross-over, comparative study. Eur J Nucl Med Mol Imaging 2023; 50:3439-3451. [PMID: 37341747 PMCID: PMC10542307 DOI: 10.1007/s00259-023-06301-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Primary objective was to compare the per-patient detection rates (DR) of [18F]DCFPyL versus [18F]fluoromethylcholine positron emission tomography/computed tomography (PET/CT), in patients with first prostate cancer (PCa) biochemical recurrence (BCR). Secondary endpoints included safety and impact on patient management (PM). METHODS This was a prospective, open label, cross-over, comparative study with randomized treatment administration of [18F]DCFPyL (investigational medicinal product) or [18F]fluoromethylcholine (comparator). Men with rising prostate-specific antigen (PSA) after initial curative therapy were enrolled. [18F]DCFPyL and [18F]fluoromethylcholine PET/CTs were performed within a maximum time interval of 12 days. DR was defined as the percentage of positive PET/CT scans identified by 3 central imaging readers. PM was assessed by comparing the proposed pre-PET/CT treatment with the local treatment", defined after considering both PET/CTs. RESULTS A total of 205 patients with first BCR after radical prostatectomy (73%; median PSA = 0.46 ng/ml [CI 0.16;27.0]) or radiation therapy (27%; median PSA = 4.23 ng/ml [CI 1.4;98.6]) underwent [18F]DCFPyL- and/or [18F]fluoromethylcholine -PET/CTs, between July and December 2020, at 22 European sites. 201 patients completed the study. The per-patient DR was significantly higher for [18F]DCFPyL- compared to [18F]fluoromethylcholine -PET/CTs (58% (117/201 patients) vs. 40% (81/201 patients), p < 0.0001). DR increased with higher PSA values for both tracers (PSA ≤ 0.5 ng/ml: 26/74 (35%) vs. 22/74 (30%); PSA 0.5 to ≤ 1.0 ng/ml: 17/31 (55%) vs. 10/31 (32%); PSA 1.01 to < 2.0 ng/ml: 13/19 (68%) vs. 6/19 (32%);PSA > 2.0: 50/57 (88%) vs. 39/57 (68%) for [18F]DCFPyL- and [18F]fluoromethylcholine -PET/CT, respectively). [18F]DCFPyL PET/CT had an impact on PM in 44% (90/204) of patients versus 29% (58/202) for [18F]fluoromethylcholine. Overall, no drug-related nor serious adverse events were observed. CONCLUSIONS The primary endpoint of this study was achieved, confirming a significantly higher detection rate for [18F]DCFPyL compared to [18F]fluoromethylcholine, in men with first BCR of PCa, across a wide PSA range. [18F]DCFPyL was safe and well tolerated.
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Affiliation(s)
- Daniela-Elena Oprea-Lager
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Eric Gontier
- Service de Médecine Nucléaire, Centre de Cancérologie de La Sarthe, Le Mans, France
| | - Lina García-Cañamaque
- Servicio de Medicina Nuclear, Grupo HM Hospitales, Universidad CEU San Pablo, Madrid, Spain
| | - Mathieu Gauthé
- Service de Médecine Nucléaire, Hôpital Tenon, Paris, France
| | | | - Mercedes Mitjavila
- Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Pilar Tamayo
- Servicio de Medicina Nuclear, IBSAL, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Philippe Robin
- Service de Médecine Nucléaire, Centre Hospitalier Universitaire de Brest, Brest, France
- UMR 1304, Inserm, Univ Brest, CHRU Brest, GETBO, Brest, France
| | | | | | - Alban Bailliez
- Service de Médecine Nucléaire Humanitep, Groupement Des Hôpitaux de L'Institut Catholique de Lille, Hôpital Saint-Philibert, Lomme, France
- Service de Médecine Nucléaire, Hôpital Privé Le Bois, Iris Imagerie, Lille, France
| | - Antonio Rodríguez-Fernández
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de Las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Sinan Ben Mahmoud
- Service de médecine nucléaire, Hôpital de Mercy, CHR Metz-Thionville, Thionville, France
| | - Juan Antonio Vallejo-Casas
- UGC Medicina Nuclear, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Philippe Maksud
- Service de médecine nucléaire Hôpital de la Pitié-Salpétriére, Sorbonne-Université, Paris, France
| | - Charles Merlin
- Service de médecine nucléaire, Centre Jean Perrin, Clermont-Ferrand, France
- Imagerie moléculaire et stratégies théranostiques, UMR1240, Université Clermont Auvergne, Inserm, Clermont-Ferrand, France
| | - Paul Blanc-Durand
- Service de médecine nucléaire, CHU H. Mondor, Créteil, France; Université Paris Est Créteil (U-PEC), Créteil, France
| | - Clément Drouet
- Service de médecine nucléaire, Centre Georges-François-Leclerc, Dijon, France
| | - Hubert Tissot
- Service de médecine nucléaire, Institut Curie, Paris, France
| | - Irina Vierasu
- Department of Nuclear Medicine, HUB, Hôpital Erasme Université libre de Bruxelles (ULB), Brussels, Belgium
| | | | | | | | | | - Caroline Rousseau
- Univ Nantes, Univ Angers, INSERM, CNRS, CRCI2NA, Nantes, France
- Service de médecine nucléaire, Institut de cancérologie de l'Ouest, Saint-Herblain, France
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Verrecchia-Ramos E, Morel O, Beauchat V, Denet S, Djibo Sidikou A, Ginet M, Pfletschinger E, Teodor L, Trombowsky M, Verdier J, Vère C, Retif P, Mahmoud SB. Personalization of 99mTc-sestamibi activity in SPECT/CT myocardial perfusion imaging with the cardiofocal SmartZoom® collimator. EJNMMI Phys 2023; 10:23. [PMID: 36959483 PMCID: PMC10036680 DOI: 10.1186/s40658-023-00545-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Patient radioprotection in myocardial perfusion imaging (MPI)-SPECT is important but difficult to optimize. The aim of this study was to adjust injected activity according to patient size-weight or BMI-by using a cardiofocal collimator camera. METHODS The correlation equation between size and observed counts in image was determined in patients who underwent stress Tc-99m-sestamibi MPI-SPECT/CT with a cardiofocal collimator-equipped conventional Anger SPECT/CT system. Image quality analyses by seven nuclear physicians were conducted to determine the minimum patient size-independent observed count threshold that yielded sufficient image quality for perfusion-defect diagnosis. These data generated an equation that can be used to calculate personalized activity for patients according to their size. RESULTS Analysis of consecutive patients (n = 294) showed that weight correlated with observed counts better than body mass index. The correlation equation was used to generate the equation that expressed the relationship between observed counts, patient weight, and injected activity. Image quality analysis with 50 images yielded an observed count threshold of 22,000 counts. Using this threshold means that the injected activity in patients with < 100 kg would be reduced (e.g., by 67% in 45-kg patients). Patients who are heavier than 100 kg would also benefit from the use of the threshold because although the injected activity would be higher (up to 78% for 150-kg patients), good image quality would be obtained. CONCLUSIONS This study provided a method for determining the optimal injected activity according to patient weight without compromising the image quality of conventional Anger SPECT/CT systems equipped with a cardiofocal collimator. Personalized injected activities for each patient weight ranging from 45 to 150 kg were generated, to standardize the resulting image quality independently of patient attenuation. This approach improves patient/staff radioprotection because it reduces the injected activity for < 100-kg patients (the majority of patients).
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Affiliation(s)
- Emilie Verrecchia-Ramos
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France.
| | - Olivier Morel
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Valérie Beauchat
- CHR Metz-Thionville, Department of Nuclear Medicine, Bel-Air Hospital, 1, Rue du Friscaty, 57100, Thionville, France
| | - Sylvie Denet
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Abdourahamane Djibo Sidikou
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Merwan Ginet
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Estelle Pfletschinger
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Luminita Teodor
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Maud Trombowsky
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Jeany Verdier
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Christelle Vère
- CHR Metz-Thionville, Department of Nuclear Medicine, Bel-Air Hospital, 1, Rue du Friscaty, 57100, Thionville, France
| | - Paul Retif
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
- Université de Lorraine, CNRS, CRAN, 54000, Nancy, France
| | - Sinan Ben Mahmoud
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
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Longo R, Wagner M, Savenkoff B, de Castaing MC, Desiro G, Tubail Z, Hennequin L, Mahmoud SB, Marcon N, Quetin P, Campitiello M, Plastino F. Correction to: A paraneoplastic limbic encephalitis from an anorectal small cell neuroendocrine carcinoma: a case report. BMC Neurol 2022; 22:81. [PMID: 35260083 PMCID: PMC8903562 DOI: 10.1186/s12883-022-02598-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Raffaele Longo
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France.
| | - Marc Wagner
- Division of Neurology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Benjamin Savenkoff
- Division of Nephrology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | | | - Guillaume Desiro
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Zead Tubail
- Division of Nephrology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Laurent Hennequin
- Division of Radiology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Sinan Ben Mahmoud
- Division of Nuclear Medecine, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Nathalie Marcon
- Division of Pathology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Philippe Quetin
- Division of Radiotherapy, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Marco Campitiello
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Francesca Plastino
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
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Verrecchia-Ramos E, Morel O, Retif P, Ben Mahmoud S. Innovative procedure for measuring left ventricular ejection fraction from 18F-FDG first-pass ultra-sensitive digital PET/CT images: evaluation with an anthropomorphic heart phantom. EJNMMI Phys 2021; 8:42. [PMID: 34018067 PMCID: PMC8137784 DOI: 10.1186/s40658-021-00387-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/04/2021] [Indexed: 11/21/2022] Open
Abstract
Background Left ventricular ejection fraction (LVEF) is usually measured by cine-cardiac magnetic resonance imaging (MRI), planar and single-photon emission-computerized tomography (SPECT) equilibrium radionuclide angiocardiography (ERNA), and echocardiography. It would be clinically useful to measure LVEF from first-pass positron-emission tomography/computed tomography (PET/CT) radionuclide angiography, but this approach has been limited by fast radiotracer diffusion. Ultra-sensitive digital PET systems can produce high-quality images within 3-s acquisition times. This study determined whether digital PET/CT accurately measured LVEF in an anthropomorphic heart phantom under conditions mimicking radiotracer first-pass into the cardiac cavities. Methods Heart phantoms in end-diastole and end-systole were 3D-printed from a patient’s MRI dataset. Reference left ventricle end-diastole volume (EDV), end-systole volume (ESV), and LVEF were determined by phantom weights before/after water filling. PET/CT (3-s acquisitions), MRI, and planar and SPECT ERNA were performed. EDV, ESV, and/or LVEF were measured by manual and automated cardiac cavity delineation, using clinical segmentation softwares. LVEF was also measured from PET images converted to 2D “pseudo-planar” images along the short axis and horizontal long axis. LVEF was also calculated for planar ERNA images. All LVEF, ESV and EDV values were compared to the reference values assessed by weighing. Results Manually calculated 3D-PET-CT-based EDV, ESV, and LVEF were close to MRI and reference values. Automated calculations on the 3D-PET-CT dataset were unreliable, suggesting that the SPECT-based tool used for this calculation is not well adapted for PET acquisitions. Manual and automated LVEF estimations from “pseudo-planar” PET images were very close/identical to MRI and reference values. Conclusions First-pass “pseudo-planar” PET may be a promising method for estimating LVEF, easy to use in clinical practice. Processing 3D PET images is also a valid method but to date suffers from a lack of well-suited software for automated LV segmentation.
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Affiliation(s)
- Emilie Verrecchia-Ramos
- Medical Physics Unit, CHR Metz-Thionville, Mercy Hospital, 1 allée du château, 57530 Ars-Laquenexy, Metz, France.
| | - Olivier Morel
- Nuclear Medicine Department, CHR Metz-Thionville, Mercy Hospital, 1 allée du château, 57530 Ars-Laquenexy, Metz, France
| | - Paul Retif
- Medical Physics Unit, CHR Metz-Thionville, Mercy Hospital, 1 allée du château, 57530 Ars-Laquenexy, Metz, France.,CNRS, CRAN, University of Lorraine, F-54000, Nancy, France
| | - Sinan Ben Mahmoud
- Nuclear Medicine Department, CHR Metz-Thionville, Mercy Hospital, 1 allée du château, 57530 Ars-Laquenexy, Metz, France
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Escobar GF, Granel-Brocard F, Schmutz JL, Cervantes P, Ben Mahmoud S, Bursztejn AC. Simultaneous response of cutaneous and lung squamous cell carcinoma with cemiplimab. Dermatol Ther 2020; 33:e13951. [PMID: 32614130 DOI: 10.1111/dth.13951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Jean-Luc Schmutz
- Department of Dermatology, Center Hospitalier Universitaire de Nancy, Nancy, France
| | - Pierre Cervantes
- Department of Pulmonology, Hospital Robert Schuman, Metz, France
| | - Sinan Ben Mahmoud
- Department of Nuclear Medicine, Center Hospitalier Régional Metz-Thionville, Metz, France
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Longo R, Wagner M, Savenkoff B, de Castaing MC, Desiro G, Tubail Z, Hennequin L, Mahmoud SB, Marcon N, Quetin P, Campitiello M, Plastino F. A paraneoplastic limbic encephalitis from an anorectal small cell neuroendocrine carcinoma: a case report. BMC Neurol 2019; 19:304. [PMID: 31783737 PMCID: PMC6884799 DOI: 10.1186/s12883-019-1542-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Paraneoplastic limbic encephalitis (PLE) is a rare autoimmune neurological syndrome observed in cancer patients. PLE is difficult to diagnose and presents a variable response to treatment, depending on the characteristics of the tumor and neuronal autoantibodies. CASE PRESENTATION A 64-year-old, Caucasian, non-smoker man presented with a rapidly developing cognitive impairment, personality change, spatial disorientation, and short-term memory loss associated with anorexia and cervical and inguinal lymph nodes. The 18F-FDG PET scan documented intensely hypermetabolic lymph nodes, which histologically corresponded to a metastasis from a small cell neuroendocrine carcinoma. The brain MRI revealed a high T2-weighted FLAIR signal of the hippocamps, consisted with a PLE. The presence of anti-neuronal Hu antibodies confirmed the diagnosis. The patient underwent plasmapheresis, associated to a systemic chemotherapy resulting in a partial and temporary improvement of the neurological symptoms. Four cycles of intravenous immunoglobulins were also necessary. After six cures of chemotherapy, the lymph node metastases regressed. However, a new anorectal lesion was detected and was histologically confirmed as a primary small cell neuroendocrine carcinoma, which was treated with concomitant chemoradiotherapy. At the end of this treatment, the patient showed a rapid tumor progression leading to his death. CONCLUSIONS This case highlights the rare entity, PLE, which is difficult to diagnose and manage. In addition, this is the first published case of PLE associated with an anorectal small cell neuroendocrine carcinoma, which appeared after completion of systemic chemotherapy.
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Affiliation(s)
- Raffaele Longo
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France.
| | - Marc Wagner
- Division of Neurology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Benjamin Savenkoff
- Division of Nephrology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | | | - Guillaume Desiro
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Zead Tubail
- Division of Nephrology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Laurent Hennequin
- Division of Radiology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Sinan Ben Mahmoud
- Division of Nuclear Medecine, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Nathalie Marcon
- Division of Pathology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Philippe Quetin
- Division of Radiotherapy, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Marco Campitiello
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Francesca Plastino
- Division of Medical Oncology, "CHR Metz-Thionville", 1 Allée du Château, 57085, Ars-Laquenexy, France
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