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Benzaquen J, Hofman P, Lopez S, Leroy S, Rouis N, Padovani B, Fontas E, Marquette CH, Boutros J. Integrating artificial intelligence into lung cancer screening: a randomised controlled trial protocol. BMJ Open 2024; 14:e074680. [PMID: 38355174 PMCID: PMC10868245 DOI: 10.1136/bmjopen-2023-074680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/21/2023] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Lung cancer (LC) is the most common cause of cancer-related deaths worldwide. Its early detection can be achieved with a CT scan. Two large randomised trials proved the efficacy of low-dose CT (LDCT)-based lung cancer screening (LCS) in high-risk populations. The decrease in specific mortality is 20%-25%.Nonetheless, implementing LCS on a large scale faces obstacles due to the low number of thoracic radiologists and CT scans available for the eligible population and the high frequency of false-positive screening results and the long period of indeterminacy of nodules that can reach up to 24 months, which is a source of prolonged anxiety and multiple costly examinations with possible side effects.Deep learning, an artificial intelligence solution has shown promising results in retrospective trials detecting lung nodules and characterising them. However, until now no prospective studies have demonstrated their importance in a real-life setting. METHODS AND ANALYSIS This open-label randomised controlled study focuses on LCS for patients aged 50-80 years, who smoked more than 20 pack-years, whether active or quit smoking less than 15 years ago. Its objective is to determine whether assisting a multidisciplinary team (MDT) with a 3D convolutional network-based analysis of screening chest CT scans accelerates the definitive classification of nodules into malignant or benign. 2722 patients will be included with the aim to demonstrate a 3-month reduction in the delay between lung nodule detection and its definitive classification into benign or malignant. ETHICS AND DISSEMINATION The sponsor of this study is the University Hospital of Nice. The study was approved for France by the ethical committee CPP (Comités de Protection des Personnes) Sud-Ouest et outre-mer III (No. 2022-A01543-40) and the Agence Nationale du Medicament et des produits de Santé (Ministry of Health) in December 2023. The findings of the trial will be disseminated through peer-reviewed journals and national and international conference presentations. TRIAL REGISTRATION NUMBER NCT05704920.
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Affiliation(s)
- Jonathan Benzaquen
- Department of Pulmonary Medicine and Thoracic Oncology, FHU OncoAge, IHU RespirERA, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, IHU RespirERA, Universite Cote d'Azur, Centre hospitalier Universitaire de Nice, Nice, France
| | | | - Sylvie Leroy
- Department of Pulmonary Medicine and Thoracic Oncology, FHU OncoAge, IHU RespirERA, Centre Hospitalier Universitaire de Nice, Nice, France
- Institut de Pharmacologie Moléculaire et Cellulaire, Nice, France
| | - Nesrine Rouis
- Department of Pulmonary Medicine and Thoracic Oncology, FHU OncoAge, IHU RespirERA, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Bernard Padovani
- Department of Radiology, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Eric Fontas
- Délégation à la Recherche Clinique et à l'Innovation, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Charles Hugo Marquette
- Department of Pulmonary Medicine and Thoracic Oncology, FHU OncoAge, IHU RespirERA, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Jacques Boutros
- Department of Pulmonary Medicine and Thoracic Oncology, FHU OncoAge, IHU RespirERA, Centre Hospitalier Universitaire de Nice, Nice, France
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Ghekiere O, Herbots L, Peters B, Berg BV, Dresselaers T, Franssen W, Padovani B, Ducreux D, Ferrari E, Nchimi A, Demanez S, De Bosscher R, Willems R, Heidbuchel H, La Gerche A, Claessen G, Bogaert J, Eijnde BO. Exercise-induced myocardial T1 increase and right ventricular dysfunction in recreational cyclists: a CMR study. Eur J Appl Physiol 2023; 123:2107-2117. [PMID: 37480391 PMCID: PMC10492712 DOI: 10.1007/s00421-023-05259-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/13/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Although cardiac troponin I (cTnI) increase following strenuous exercise has been observed, the development of exercise-induced myocardial edema remains unclear. Cardiac magnetic resonance (CMR) native T1/T2 mapping is sensitive to the pathological increase of myocardial water content. Therefore, we evaluated exercise-induced acute myocardial changes in recreational cyclists by incorporating biomarkers, echocardiography and CMR. METHODS Nineteen male recreational participants (age: 48 ± 5 years) cycled the 'L'étape du tour de France" (EDT) 2021' (175 km, 3600 altimeters). One week before the race, a maximal graded cycling test was conducted to determine individual heart rate (HR) training zones. One day before and 3-6 h post-exercise 3 T CMR and echocardiography were performed to assess myocardial native T1/T2 relaxation times and cardiac function, and blood samples were collected. All participants were asked to cycle 2 h around their anaerobic gas exchange threshold (HR zone 4). RESULTS Eighteen participants completed the EDT stage in 537 ± 58 min, including 154 ± 61 min of cycling time in HR zone 4. Post-race right ventricular (RV) dysfunction with reduced strain and increased volumes (p < 0.05) and borderline significant left ventricular global longitudinal strain reduction (p = 0.05) were observed. Post-exercise cTnI (0.75 ± 5.1 ng/l to 69.9 ± 41.6 ng/l; p < 0.001) and T1 relaxation times (1133 ± 48 ms to 1182 ± 46 ms, p < 0.001) increased significantly with no significant change in T2 (p = 0.474). cTnI release correlated with increase in T1 relaxation time (p = 0.002; r = 0.703), post-race RV dysfunction (p < 0.05; r = 0.562) and longer cycling in HR zone 4 (p < 0.05; r = 0.607). CONCLUSION Strenuous exercise causes early post-race cTnI increase, increased T1 relaxation time and RV dysfunction in recreational cyclists, which showed interdependent correlation. The long-term clinical significance of these changes needs further investigation. TRIAL REGISTRATION NUMBERS AND DATE NCT04940650 06/18/2021. NCT05138003 06/18/2021.
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Affiliation(s)
- Olivier Ghekiere
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium.
- Department of Radiology and Department of Jessa & Science, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.
| | - Lieven Herbots
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium
- Heart Centre, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Benjamin Peters
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium
- Department of Radiology and Department of Jessa & Science, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | | | - Tom Dresselaers
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Wouter Franssen
- SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Nutrition and Movement Sciences; NUTRIM, School for Nutrition and Translation Research Maastricht, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | | | - Emile Ferrari
- Department of Cardiology, University Hospital Nice, Nice, France
| | - Alain Nchimi
- Department of Radiology, Centre Hospitalier Universitaire Luxembourg, Luxembourg, Luxembourg
| | - Sophie Demanez
- Department of Cardiology, Centre Cardiologique Orban, Liège, Belgium
| | - Ruben De Bosscher
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Rik Willems
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - Andre La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Guido Claessen
- Faculty of Medicine and Life Sciences/LCRC (-MHU), Hasselt University, Agoralaan, 3590, Diepenbeek, Belgium
- Heart Centre, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Jan Bogaert
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Bert O Eijnde
- SMRC Sports Medical Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
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Benzaquen J, Bondiau PY, Otto J, Marquette CH, Berthet JP, Naghavi AO, Schiappa R, Hannoun-Levi JM, Padovani B, Doyen J. Comparison of outcome after stereotactic ablative radiotherapy of patients with metachronous lung versus primary lung cancer. Radiat Oncol 2023; 18:97. [PMID: 37287020 DOI: 10.1186/s13014-023-02286-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 05/20/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Early-stage lung cancer, primarily treated with surgery, often occur in poor surgical candidates (impaired respiratory function, prior thoracic surgery, severe comorbidities). Stereotactic ablative radiotherapy (SABR) is a non-invasive alternative that provides comparable local control. This technique is particularly relevant for surgically resectable metachronous lung cancer, in patients unable to undergo surgery.. The objective of this study is to evaluate the clinical outcome of patients treated with SABR for stage I metachronous lung cancer (MLC) versus stage I primary lung cancer (PLC). PATIENTS AND METHODS 137 patients treated with SABR for stage I non-small cell lung cancer were retrospectively reviewed, of which 28 (20.4%) were MLC and 109 (79.6%) were PLC. Cohorts were evaluated for differences in overall survival (OS), progression-free survival (PFS), metastasis-free survival, local control (LC), and toxicity. RESULTS After SABR, patients treated for MLC have comparable median age (76.6 vs 78.6, p = 0.2), 3-year LC (83.6% vs. 72.6%, p = 0.2), PFS (68.7% vs. 50.9%, p = 0.9), and OS (78.6% vs. 52.1%, p = 0.9) as PLC, along with similar rates of total (54.1% vs. 42.9%, p = 0.6) and grade 3 + toxicity (3.7% vs. 3.6%, p = 0.9). Previous treatment of MLC patients was either surgery (21/28, 75%) or SABR (7/28, 25%). The median follow-up was 53 months. CONCLUSION SABR is a safe and effective approach for localized metachronous lung cancer.
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Affiliation(s)
- Jonathan Benzaquen
- Department of Pulmonary Medicine and Thoracic Oncology, Nice University Hospital, Pasteur Hospital, FHU OncoAge, Côte d'Azur University, 30, Voie Romaine, 06000, Nice, France.
- CNRS, INSERM, Institute of Research On Cancer and Aging, Côte d'Azur University, Nice, France.
| | - Pierre-Yves Bondiau
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Josiane Otto
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Charles-Hugo Marquette
- Department of Pulmonary Medicine and Thoracic Oncology, Nice University Hospital, Pasteur Hospital, FHU OncoAge, Côte d'Azur University, 30, Voie Romaine, 06000, Nice, France
- CNRS, INSERM, Institute of Research On Cancer and Aging, Côte d'Azur University, Nice, France
| | - Jean-Philippe Berthet
- Department of Thoracic Surgery, Nice University Hospital, Pasteur Hospital, Nice, France
| | - Arash O Naghavi
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Renaud Schiappa
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Jean-Michel Hannoun-Levi
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | - Bernard Padovani
- Department of Radiology, Nice University Hospital, Côte d'Azur University, Nice, France
| | - Jérôme Doyen
- CNRS, INSERM, Institute of Research On Cancer and Aging, Côte d'Azur University, Nice, France
- Department of Medical Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
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Audelan B, Lopez S, Fillard P, Diascorn Y, Padovani B, Delingette H. Validation of lung nodule detection a year before diagnosis in NLST dataset based on a deep learning system. Lung Cancer 2021. [DOI: 10.1183/13993003.congress-2021.oa4317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Marquette CH, Boutros J, Benzaquen J, Ferreira M, Pastre J, Pison C, Padovani B, Bettayeb F, Fallet V, Guibert N, Basille D, Ilie M, Hofman V, Hofman P. Circulating tumour cells as a potential biomarker for lung cancer screening: a prospective cohort study. Lancet Respir Med 2020; 8:709-716. [PMID: 32649919 DOI: 10.1016/s2213-2600(20)30081-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Lung cancer screening with low-dose chest CT (LDCT) reduces the mortality of eligible individuals. Blood signatures might act as a standalone screening tool, refine the selection of patients at risk, or help to classify undetermined nodules detected on LDCT. We previously showed that circulating tumour cells (CTCs) could be detected, using the isolation by size of epithelial tumour cell technique (ISET), long before the cancer was diagnosed radiologically. We aimed to test whether CTCs could be used as a biomarker for lung cancer screening. METHODS We did a prospective, multicentre, cohort study in 21 French university centres. Participants had to be eligible for lung cancer screening as per National Lung Screening Trial criteria and have chronic obstructive pulmonary disease with a fixed airflow limitation defined as post-bronchodilator FEV1/FVC ratio of less than 0·7. Any cancer, other than basocellular skin carcinomas, detected within the previous 5 years was the main exclusion criterion. Participants had three screening rounds at 1-year intervals (T0 [baseline], T1, and T2), which involved LDCT, clinical examination, and a blood test for CTCs detection. Participants and investigators were masked to the results of CTC detection, and cytopathologists were masked to clinical and radiological findings. Our primary objective was to test the diagnostic performance of CTC detection using the ISET technique in lung cancer screening, compared with cancers diagnosed by final pathology, or follow up if pathology was unavailable as the gold standard. This study is registered with ClinicalTrials.gov identifier, number NCT02500693. FINDINGS Between Oct 30, 2015, and Feb 2, 2017, we enrolled 614 participants, predominantly men (437 [71%]), aged 65·1 years (SD 6·5), and heavy smokers (52·7 pack-years [SD 21·5]). 81 (13%) participants dropped out between baseline and T1, and 56 (11%) did between T1 and T2. Nodules were detected on 178 (29%) of 614 baseline LDCTs. 19 participants (3%) were diagnosed with a prevalent lung cancer at T0 and 19 were diagnosed with incident lung cancer (15 (3%) of 533 at T1 and four (1%) of 477 at T2). Extrapulmonary cancers were diagnosed in 27 (4%) of participants. Overall 28 (2%) of 1187 blood samples were not analysable. At baseline, the sensitivity of CTC detection for lung cancer detection was 26·3% (95% CI 11·8-48·8). ISET was unable to predict lung cancer or extrapulmonary cancer development. INTERPRETATION CTC detection using ISET is not suitable for lung cancer screening. FUNDING French Government, Conseil Départemental 06, Fondation UNICE, Fondation Aveni, Fondation de France, Ligue Contre le Cancer-Comité des Alpes-Maritimes, ARC (Canc'Air Genexposomics), Claire de Divonne-Pollner, Enca Faidhi, Basil Faidhi, Fabienne Mourou, Michel Mourou, Leonid Fridlyand, cogs4cancer, and the Fondation Masikini.
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Affiliation(s)
- Charles-Hugo Marquette
- Department of Pulmonary Medicine and Oncology, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Institute of Research on Cancer and Aging, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France.
| | - Jacques Boutros
- Department of Pulmonary Medicine and Oncology, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France
| | - Jonathan Benzaquen
- Department of Pulmonary Medicine and Oncology, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Institute of Research on Cancer and Aging, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Marion Ferreira
- Department of Pulmonary Medicine, Centre Hospitalier Régional Universitaire Tours, Tours, France
| | - Jean Pastre
- Department of Pulmonary Medicine, Hôpital Européen Georges Pompidou, Paris, France
| | - Christophe Pison
- Centre Hospitalier Universitaire Grenoble Alpes, Service Hospitalier Universitaire Pneumologie Physiologie, Université Grenoble Alpes, Grenoble, France
| | - Bernard Padovani
- Department of Radiology, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Faiza Bettayeb
- Clinique des bronches, allergies, et sommeil, Centre Hospitalier Universitaire de Marseille, Institut National de la Santé et de la Recherche Médicale, Centre Recherche en Cardiovasculaire et Nutrition, Aix Marseille Université, Marseille, France
| | - Vincent Fallet
- Sorbonne Université, Groupe de Recherche Clinique 4, Theranoscan, Assistance Publique - Hôpitaux de Paris, Service de Pneumologie, Hôpital Tenon, Paris, France
| | - Nicolas Guibert
- Department of Pulmonary Medicine, Centre Hospitalier Universitaire Toulouse, Toulouse, France
| | - Damien Basille
- Department of Pulmonary Medicine, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Hospital-Related Biobank, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Institute of Research on Cancer and Aging, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Hospital-Related Biobank, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Institute of Research on Cancer and Aging, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Hospital-Related Biobank, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, University Hospital Federation OncoAge, Nice, France; Institute of Research on Cancer and Aging, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
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Boutros J, Benzaquen J, Delin M, Padovani B, Marquette CH, Leroy S. Exuberant cystic destruction of lung parenchyma. Respir Med Res 2020; 78:100755. [PMID: 32473555 DOI: 10.1016/j.resmer.2020.100755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/24/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Affiliation(s)
- J Boutros
- FHU OncoAge, department of pulmonary medicine, université Côte d'Azur, CHU de Nice, Nice, France.
| | - J Benzaquen
- FHU OncoAge, department of pulmonary medicine, université Côte d'Azur, CHU de Nice, Nice, France; FHU OncoAge, CNRS UMR7284, Inserm U1081, Institute of research on cancer and ageing (IRCAN), université Côte d'Azur, Nice, France
| | - M Delin
- FHU OncoAge, department of pulmonary medicine, université Côte d'Azur, CHU de Nice, Nice, France
| | - B Padovani
- Department of radiology, université Côte d'Azur, CHU de Nice, Nice, France
| | - C-H Marquette
- FHU OncoAge, department of pulmonary medicine, université Côte d'Azur, CHU de Nice, Nice, France; FHU OncoAge, CNRS UMR7284, Inserm U1081, Institute of research on cancer and ageing (IRCAN), université Côte d'Azur, Nice, France
| | - S Leroy
- FHU OncoAge, department of pulmonary medicine, université Côte d'Azur, CHU de Nice, Nice, France; CNRS UMR 7275, institut de pharmacologie moléculaire et cellulaire, université Côte d'Azur, Sophia-Antipolis, France
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Padovani B, Boutros J, Marquette CH, Hofman V, Ducreux D, Mouroux J, Diascorn Y, Leroy S. CT-guided percutaneous biopsies of mediastinal and paramediastinal masses in the lateral decubitus position. Eur Radiol 2020; 30:3146-3151. [PMID: 32065281 DOI: 10.1007/s00330-020-06659-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/11/2019] [Accepted: 01/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Percutaneous parasternal puncture is a common procedure that allows sampling of mediastinal lesions. The trans-pulmonary route is sometimes mandatory in the dorsal position and is associated with complications such as pneumothorax. METHODS Our study explored the efficacy of the lateral decubitus position in avoiding the trans-pulmonary route. Sixteen patients were included between 2005 and 2019. In three patients, the procedure was intended to place fiducial markers. RESULTS No pneumothorax or hematoma occurred. Access to the lesion was not possible in 1 patient. A histological diagnosis was made for all patients undergoing sampling. This technique seems to be safe and efficient. KEY POINTS • Parasternal access to mediastinal and paramediastinal lesions whenever a trans-pulmonary crossing is mandatory in the dorsal position is safe, simple, and efficient in the lateral decubitus position.
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Affiliation(s)
- Bernard Padovani
- Department of Radiology, Université Côte d'Azur, CHU de Nice, Nice, France.
| | - Jacques Boutros
- Department of Pulmonary Medicine, Université Côte d'Azur, CHU de Nice, Nice, France
| | - Charles-Hugo Marquette
- Department of Pulmonary Medicine, Université Côte d'Azur, CHU de Nice, Nice, France.,FHU OncoAge, CNRS UMR7284, Inserm U1081, Institute of Research on Cancer and Ageing (IRCAN), Université Côte d'Azur, Nice, France
| | - Véronique Hofman
- FHU OncoAge, CNRS UMR7284, Inserm U1081, Institute of Research on Cancer and Ageing (IRCAN), Université Côte d'Azur, Nice, France.,FHU OncoAge, Centre Hospitalier Universitaire de Nice, Laboratory of Clinical and Experimental Pathology, Université Côte d'Azur, Nice, France
| | - Dorothée Ducreux
- Department of Radiology, Université Côte d'Azur, CHU de Nice, Nice, France
| | - Jérome Mouroux
- Department of Thoracic Surgery, CHU de Nice, Université Côte d'Azur, Nice, France
| | - Yann Diascorn
- Department of Radiology, Université Côte d'Azur, CHU de Nice, Nice, France
| | - Sylvie Leroy
- Department of Pulmonary Medicine, Université Côte d'Azur, CHU de Nice, Nice, France.,CNRS UMR 7275, Institut de Pharmacologie Moléculaire et Cellulaire, Université Côte d'Azur, Sophia Antipolis, France
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Moceri P, Baudouy D, Squara F, Padovani B, Ferrari E. Multi-modality imaging in repaired anomalous left coronary artery arising from the pulmonary artery. Eur Heart J Cardiovasc Imaging 2018; 19:952. [PMID: 29562240 DOI: 10.1093/ehjci/jey046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 03/05/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pamela Moceri
- Service de Cardiologie, Centre Hospitalier Universitaire de Nice-Hôpital Pasteur, Avenue de la voie romaine, CS 51069-06001 Nice, France.,Université Côte d'Azur, Faculté de médecine, 28 Avenue de Valombrose, 06107 Nice, France
| | - Delphine Baudouy
- Service de Cardiologie, Centre Hospitalier Universitaire de Nice-Hôpital Pasteur, Avenue de la voie romaine, CS 51069-06001 Nice, France
| | - Fabien Squara
- Service de Cardiologie, Centre Hospitalier Universitaire de Nice-Hôpital Pasteur, Avenue de la voie romaine, CS 51069-06001 Nice, France
| | - Bernard Padovani
- Université Côte d'Azur, Faculté de médecine, 28 Avenue de Valombrose, 06107 Nice, France.,Service de Radiologie, Centre Hospitalier Universitaire de Nice-Hôpital Pasteur 2, Avenue de la voie romaine, 06001 Nice, France
| | - Emile Ferrari
- Service de Cardiologie, Centre Hospitalier Universitaire de Nice-Hôpital Pasteur, Avenue de la voie romaine, CS 51069-06001 Nice, France.,Université Côte d'Azur, Faculté de médecine, 28 Avenue de Valombrose, 06107 Nice, France
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Doyen J, Poudenx M, Gal J, Otto J, Guerder C, Naghavi AO, Gérard A, Leysalle A, Cohen C, Padovani B, Ianessi A, Schiappa R, Chamorey E, Bondiau PY. Stereotactic ablative radiotherapy after concomitant chemoradiotherapy in non-small cell lung cancer: A TITE-CRM phase 1 trial. Radiother Oncol 2018; 127:239-245. [PMID: 29650404 DOI: 10.1016/j.radonc.2018.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 03/14/2018] [Accepted: 03/26/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Platinum based chemoradiotherapy is the standard of care for inoperable non-small cell lung cancer (NSCLC). With evidence that NSCLC can have a dose dependent response with stereotactic ablative radiotherapy (SABR), we hypothesize that a SABR boost on residual tumor treated with chemoradiotherapy could increase treatment efficacy. The purpose of this study was to determine feasibility of such an approach. MATERIAL AND METHODS A prospective phase I trial was performed including 26 patients. Time-to-event continual reassessment method (TITE-CRM) was used for dose escalation which ranged from 3 × 7 to 3 × 12 Gy for the stereotactic boost, after 46 Gy (2 Gy per day) of chemoradiotherapy. RESULTS Median follow-up was of 37.1 months (1.7-60.7), and 3, 4, 3, 3, 9 and 4 patients were included at the dose levels 1, 2, 3, 4, 5 and 6, respectively. During chemoradiotherapy, 9 patients experienced grade 3 toxicity. After stereotactic radiotherapy, 1 patient experienced an esophageal fistula (with local relapse) at the 3 × 11 Gy level, and 1 patient died from hemoptysis at the 3 × 12 Gy level. The 2-year rate of local control, locoregional free survival, metastasis-free survival, and overall survival was 70.3%, 55.5%, 44.5% and 50.8%, respectively. CONCLUSION In the treatment of NSCLC with chemoradiotherapy followed by a stereotactic boost, the safe recommended dose in our protocol was a boost dose of 3 × 11 Gy.
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Affiliation(s)
- Jérôme Doyen
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France.
| | - Michel Poudenx
- University of Côte d'Azur, Nice, France; Departement of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Jocelyn Gal
- University of Côte d'Azur, Nice, France; Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Josiane Otto
- University of Côte d'Azur, Nice, France; Departement of Medical Oncology, Centre Antoine-Lacassagne, Nice, France
| | - Caroline Guerder
- Department of Radiation Oncology, Hôpital de la croix-rouge française, Toulon, France
| | - Arash O Naghavi
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, United States
| | - Anais Gérard
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
| | - Axel Leysalle
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
| | - Charlotte Cohen
- University of Côte d'Azur, Nice, France; Department of Thoracic Surgery, Centre Hospitalo-Universitaire de Nice, France
| | - Bernard Padovani
- University of Côte d'Azur, Nice, France; Department of Radiology, Centre Hospitalo-Universitaire de Nice, France
| | - Antoine Ianessi
- University of Côte d'Azur, Nice, France; Department of Radiology, Centre Antoine-Lacassagne, Nice, France
| | - Renaud Schiappa
- University of Côte d'Azur, Nice, France; Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Emmanuel Chamorey
- University of Côte d'Azur, Nice, France; Department of Biostatistics, Centre Antoine-Lacassagne, Nice, France
| | - Pierre-Yves Bondiau
- Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France; University of Côte d'Azur, Nice, France
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Reverso-Meinietti J, Vandenbos F, Risso K, Coyne J, Leroy S, Padovani B, Burel-Vandenbos F. [Pulmonary intravascular talcosis: A case report]. Rev Med Interne 2018; 39:658-660. [PMID: 29650301 DOI: 10.1016/j.revmed.2018.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/30/2017] [Revised: 02/22/2018] [Accepted: 03/09/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Pulmonary intravascular talcosis is a rare condition occurring in intravenous drug users injecting oral medications. Talc results in a foreign-body granulomatous reaction giving a radiological haematogenic miliary appearance mimicking miliary tuberculosis. Drug users represent a population at risk for both these conditions and their distinction may be challenging. CASE REPORT We reported the case of a man, 33 year-old, intravenous drug addict, detected by the health services because he was the partner of a person who died of contagious and multi-resistant tuberculosis. Chest X-ray and CT scan showed a typical miliary appearance. Despite negative microbiology, clinical diagnosis of miliary tuberculosis was retained. Due to the lack of radiological improvement despite appropriate antibiotic treatment, re-evaluation and trans-bronchial biopsy were undertaken. The presence of granulomas centered by birefringent foreign bodies in polarized light led to a diagnosis of pulmonary intravascular talcosis. CONCLUSION In the presence of pulmonary miliary in an intravenous drug addict, intravascular talcosis should be suspected.
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Affiliation(s)
- J Reverso-Meinietti
- Laboratoire central d'anatomie pathologique, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie Romaine, 06000 Nice, France
| | - F Vandenbos
- Centre de soins de suite et de rééducation cardiorespiratoire « La Maison du Mineur », 755, avenue Henri-Giraud, 06140 Vence, France
| | - K Risso
- Service de maladies infectieuses et tropicales, hôpital l'Archet I, centre hospitalier universitaire de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France
| | - J Coyne
- Laboratoire central d'anatomie pathologique, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie Romaine, 06000 Nice, France
| | - S Leroy
- Service de pneumologie, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie romaine, 06000 Nice, France
| | - B Padovani
- Service de radiologie, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie romaine, 06000 Nice, France
| | - F Burel-Vandenbos
- Laboratoire central d'anatomie pathologique, hôpital Pasteur, centre hospitalier universitaire de Nice, 30, voie Romaine, 06000 Nice, France.
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Benzaquen J, Pradelli J, Padovani B, Marquette CH, Leroy S. [Emphysema, did you say emphysema?]. Rev Mal Respir 2018; 35:83-87. [PMID: 29402641 DOI: 10.1016/j.rmr.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 06/20/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a common condition that may initially look simple but may conceal other diseases capable of accelerating its natural history or even simulating it. We describe four cases presenting as COPD with emphysema that were reclassified on the basis of certain clinical characteristics and the radiological pattern. CASE REPORTS A 52 year old never smoking woman presenting with emphysema was eventually diagnosed as having lymphangioleiomyomatosis on the basis of an abdominal CT scan showing kidney angiomyolipomas. A 44 years old smoker presenting with rapidly evolving emphysema was eventually diagnosed as having Langerhans cell histiocytosis on the basis of a previous chest CT (four years earlier) showing cavitating nodules. An airport refueler, 73 years old, with severe emphysema despite never having smoked, was eventually diagnosed as suffering from alpha-1 antitrypsin deficiency. The last patient was a 54 year old man, a never smoker, who presented with severe airflow limitation and multilobar hyperlucency, with bronchiectasis in the same areas. He was eventually diagnosed as having a severe form of the Swyer-James-MacLeod syndrome. CONCLUSION These four case reports underline the importance of questioning the diagnosis of COPD when certain particular phenotypic characteristics are identified.
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Affiliation(s)
- J Benzaquen
- Service de pneumologie, hôpital Pasteur, universite Côte-d'Azur, FHU OncoAge, centre hospitalier universitaire de Nice, 06000 Nice, France.
| | - J Pradelli
- Service de pneumologie, hôpital Pasteur, universite Côte-d'Azur, FHU OncoAge, centre hospitalier universitaire de Nice, 06000 Nice, France
| | - B Padovani
- Service de radiologie, universite Côte-d'Azur, FHU OncoAge, CHU de Nice, 06000 Nice, France
| | - C H Marquette
- Service de pneumologie, hôpital Pasteur, universite Côte-d'Azur, FHU OncoAge, centre hospitalier universitaire de Nice, 06000 Nice, France
| | - S Leroy
- Service de pneumologie, hôpital Pasteur, universite Côte-d'Azur, FHU OncoAge, centre hospitalier universitaire de Nice, 06000 Nice, France
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Leroy S, Benzaquen J, Mazzetta A, Marchand-Adam S, Padovani B, Israel-Biet D, Pison C, Chanez P, Cadranel J, Mazières J, Jounieaux V, Cohen C, Hofman V, Ilie M, Hofman P, Marquette CH. Circulating tumour cells as a potential screening tool for lung cancer (the AIR study): protocol of a prospective multicentre cohort study in France. BMJ Open 2017; 7:e018884. [PMID: 29282271 PMCID: PMC5770962 DOI: 10.1136/bmjopen-2017-018884] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Lung cancer (LC) is the leading cause of death from cancer. Early diagnosis of LC is of paramount importance in terms of prognosis. The health authorities of most countries do not accept screening programmes based on low-dose chest CT (LDCT), especially in Europe, because they are flawed by a high rate of false-positive results, leading to a large number of invasive diagnostic procedures. These authorities advocated further research, including companion biological tests that could enhance the effectiveness of LC screening. The present project aims to validate early diagnosis of LC by detection and characterisation of circulating tumour cells (CTCs) in a peripheral blood sample taken from a prospective cohort of persons at high-risk of LC. METHODS AND ANALYSIS The AIR Project is a prospective, multicentre, double-blinded, cohort study conducted by a consortium of 21 French university centres. The primary objective is to determine the operational values of CTCs for the early detection of LC in a cohort of asymptomatic participants at high risk for LC, that is, smokers and ex-smokers (≥30 pack-years, quitted ≤15 years), aged ≥55 years, with chronic obstructive pulmonary disease (COPD). The study participants will undergo yearly screening rounds for 3 years plus a 1-year follow-up. Each round will include LDCT plus peripheral blood sampling for CTC detection. Assuming 5% prevalence of LC in the studied population and a 10% dropout rate, a total of at least 600 volunteers will be enrolled. ETHICS AND DISSEMINATION The study sponsor is the University Hospital of Nice. The study was approved for France by the ethical committee CPP Sud-Méditerranée V and the ANSM (Ministry of Health) in July 2015. The findings of the trial will be disseminated through peer-reviewed journals and national and international conference presentations. TRIAL REGISTRATION NUMBER NCT02500693.
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Affiliation(s)
- Sylvie Leroy
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
- CNRS, INSERM, IPMC, FHU-OncoAge, Université Côte d'Azur, Valbonne, France
| | - Jonathan Benzaquen
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Andrea Mazzetta
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | | | | | - Christophe Pison
- Department of Pulmonary Medicine, CHU de Grenoble, Grenoble, France
| | - Pascal Chanez
- Department of Pulmonary Medicine, CHU de Marseille, Marseille, France
| | | | - Julien Mazières
- Department of Pulmonary Medicine, CHU Toulouse, Toulouse, France
| | | | - Charlotte Cohen
- Department of Thoracic Surgery, CHU de Nice, FHU OncoAge, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
| | - Charles Hugo Marquette
- Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Nice, France
- Laboratory of Clinical and Experimental Pathology, Hospital-Related Biobank (BB-0033-00025), IRCAN, FHU OncoAge, Nice, France
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13
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Kinj R, Bondiau PY, François E, Gérard JP, Naghavi AO, Leysalle A, Chamorey E, Evesque L, Padovani B, Ianessi A, Benezery K, Doyen J. Radiosensitivity of Colon and Rectal Lung Oligometastasis Treated With Stereotactic Ablative Radiotherapy. Clin Colorectal Cancer 2017; 16:e211-e220. [DOI: 10.1016/j.clcc.2016.08.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 08/02/2016] [Accepted: 08/18/2016] [Indexed: 12/31/2022]
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Chardin D, Nivaggioni G, Viau P, Butori C, Padovani B, Grangeaon C, Razzouk-Cadet M. False positive 18FDG PET-CT results due to exogenous lipoid pneumonia secondary to oily drug inhalation: A case report. Medicine (Baltimore) 2017; 96:e6889. [PMID: 28562539 PMCID: PMC5459704 DOI: 10.1097/md.0000000000006889] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Exogenous lipoid pneumonia is a rare condition due to abnormal presence of oily substances in the lungs. It is a rarely known cause for false positive FDG PET-CT results and can sometimes lead to invasive investigations. Searching and finding the source of the oily substance is one of the keys to the diagnosis. Inhalation of oily drugs during snorting has rarely been described. PATIENT CONCERNS A patient with well controlled HIV infection was referred for an FDG PET-CT to assess extension of Kaposi's disease, recently removed from his right foot. The patient had no particular symptoms. DIAGNOSES Abnormal uptake of FDG was found in a suspicious lung nodule. An experienced radiologist thought the nodule was due to lipoid pneumonia. INTERVENTIONS Bronchoalveolar lavage fluid did not contain lipid-laden macrophages but bronchoscopy showed violet lesions resembling Kaposi's disease lesions. Lobectomy was performed after a multidisciplinary discussion. OUTCOMES Anatomopathological analysis revealed the nodule was due to lipoid pneumonia. The patient's quality of life did not diminish after the operation and he is still in good health. The source of the oily substance causing lipoid pneumonia was found after the surgery: the patient used to snort oily drugs. LESSONS The presence of a suspicious lung nodule possibly due to lipoid pneumonia in a patient with known Kaposi's disease was difficult to untangle and lead to invasive surgery. It is possible that if a source of exogenous lipoid pneumonia had been found beforehand, surgery could have been prevented.
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Affiliation(s)
- David Chardin
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | - Guillaume Nivaggioni
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | - Philippe Viau
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | | | - Bernard Padovani
- Department of Radiology, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Pasteur II, Nice, France
| | - Caroline Grangeaon
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
| | - Micheline Razzouk-Cadet
- Department of Nuclear Medicine, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet I
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Doyen J, Leysalle A, Gal J, Poudenx M, Otto J, Guerder C, Padovani B, Venissac N, Bondiau P. Chimioradiothérapie concomitante suivie d’une irradiation stéréotaxique des cancers bronchiques non à petite cellules : résultats finaux de l’essai de phase 1 Cybertaxcis. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.07.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Elkind L, Bondiau PY, Padovani B, Lanessi A. Évaluation de la faisabilité et des complications de la mise en place de grains fiduciels « Gold Anchor 25 G » par ponction transpariétale sous scanographie avant radiothérapie par CyberKnife® des nodules pulmonaires. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Marsaud A, Durand M, Raffaelli C, Carpentier X, Rouscoff Y, Tibi B, Floc’h A, De Villeneuve M, Haider R, Ambrosetti D, Fontas E, Padovani B, Amiel J, Chevallier D. Apport de l’élastographie en temps réel pour la caractérisation des masses testiculaires. Prog Urol 2015; 25:75-82. [DOI: 10.1016/j.purol.2014.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 10/10/2014] [Accepted: 11/28/2014] [Indexed: 12/21/2022]
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Quatrehomme G, Biglia E, Padovani B, du Jardin P, Alunni V. Positive identification by X-rays bone trabeculae comparison. Forensic Sci Int 2014; 245:e11-4. [DOI: 10.1016/j.forsciint.2014.09.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 07/30/2014] [Accepted: 09/21/2014] [Indexed: 11/28/2022]
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Ilie M, Hofman V, Long-Mira E, Selva E, Vignaud JM, Padovani B, Mouroux J, Marquette CH, Hofman P. "Sentinel" circulating tumor cells allow early diagnosis of lung cancer in patients with chronic obstructive pulmonary disease. PLoS One 2014; 9:e111597. [PMID: 25360587 PMCID: PMC4216113 DOI: 10.1371/journal.pone.0111597] [Citation(s) in RCA: 260] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 10/01/2014] [Indexed: 12/17/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a risk factor for lung cancer. Migration of circulating tumor cells (CTCs) into the blood stream is an early event that occurs during carcinogenesis. We aimed to examine the presence of CTCs in complement to CT-scan in COPD patients without clinically detectable lung cancer as a first step to identify a new marker for early lung cancer diagnosis. The presence of CTCs was examined by an ISET filtration-enrichment technique, for 245 subjects without cancer, including 168 (68.6%) COPD patients, and 77 subjects without COPD (31.4%), including 42 control smokers and 35 non-smoking healthy individuals. CTCs were identified by cytomorphological analysis and characterized by studying their expression of epithelial and mesenchymal markers. COPD patients were monitored annually by low-dose spiral CT. CTCs were detected in 3% of COPD patients (5 out of 168 patients). The annual surveillance of the CTC-positive COPD patients by CT-scan screening detected lung nodules 1 to 4 years after CTC detection, leading to prompt surgical resection and histopathological diagnosis of early-stage lung cancer. Follow-up of the 5 patients by CT-scan and ISET 12 month after surgery showed no tumor recurrence. CTCs detected in COPD patients had a heterogeneous expression of epithelial and mesenchymal markers, which was similar to the corresponding lung tumor phenotype. No CTCs were detected in control smoking and non-smoking healthy individuals. CTCs can be detected in patients with COPD without clinically detectable lung cancer. Monitoring “sentinel” CTC-positive COPD patients may allow early diagnosis of lung cancer.
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Affiliation(s)
- Marius Ilie
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
- IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
- IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice, France
| | - Eric Selva
- Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
| | - Jean-Michel Vignaud
- Department of Pathology, Central Hospital, University of Nancy, Nancy, France
| | | | - Jérôme Mouroux
- Department of Thoracic Surgery, Pasteur Hospital, Nice, France
| | - Charles-Hugo Marquette
- IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice, France
- Department of Pulmonary Medicine, Pasteur Hospital, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice, France
- Human Biobank BB-0033-00025, Pasteur Hospital, Nice, France
- IRCAN Team 3, INSERM U1081/UMR CNRS 7284, Faculty of Medicine of Nice, University of Nice Sophia Antipolis, Nice, France
- * E-mail:
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Doyen J, Leysalle A, Poudenx M, Otto J, Venissac N, Angellier G, Padovani B, Bondiau P. Chimioradiothérapie concomitante suivie d’une irradiation stéréotaxique des cancers bronchiques non à petites cellules : essai de phase 1 CYBERTAXCIS. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2014.07.099] [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: 11/29/2022]
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21
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Baque-Juston M, Pellegrin A, Leroy S, Marquette CH, Padovani B. Organizing pneumonia: what is it? A conceptual approach and pictorial review. Diagn Interv Imaging 2014; 95:771-7. [PMID: 24559802 DOI: 10.1016/j.diii.2014.01.004] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Organizing pneumonia (formerly named bronchiolitis obliterans with organizing pneumonia or BOOP) is a clinical, radiological and histological entity that is classified as an Interstitial Lung Disease. The understanding of this family of diseases has seen great progress over the past twenty years. CT presentation of organizing pneumonia is polymorphous but a few patterns have been recently recognized as being more specific to this diagnosis. The aim of this work is to summarize new understandings of the clinical and histological presentation of the disease and to review the most relevant CT features.
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Affiliation(s)
- M Baque-Juston
- Department of Radiology, Hospital Pasteur, 30, avenue de la Voie-Romaine, 06003 Nice cedex 1, France.
| | - A Pellegrin
- Department of Radiology, Hospital Pasteur, 30, avenue de la Voie-Romaine, 06003 Nice cedex 1, France
| | - S Leroy
- Department of Respiratory Medicine, Hospital Pasteur, 30, avenue de la Voie-Romaine, 06003 Nice cedex 1, France
| | - C H Marquette
- Department of Respiratory Medicine, Hospital Pasteur, 30, avenue de la Voie-Romaine, 06003 Nice cedex 1, France
| | - B Padovani
- Department of Radiology, Hospital Pasteur, 30, avenue de la Voie-Romaine, 06003 Nice cedex 1, France
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Sedat J, Chau Y, Mondot L, Chemla R, Lonjon M, Padovani B. Is eptifibatide a safe and effective rescue therapy in thromboembolic events complicating cerebral aneurysm coil embolization? Single-center experience in 42 cases and review of the literature. Neuroradiology 2013; 56:145-53. [PMID: 24281387 DOI: 10.1007/s00234-013-1301-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 11/02/2013] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Thromboembolic complications are the most frequent perioperative complications of endovascular treatment of intracranial aneurysms. Even if the effectiveness of glycoprotein IIb/IIIa inhibitors has been reported, the outcomes in published clinic data are contradictory. This study aims to assess the effectiveness and the safety of eptifibatide in thromboembolic complications during intracranial aneurysm embolization procedure. METHODS Between 2006 and 2012, 650 patients with intracranial aneurysm were treated using endovascular coil embolization, and in 62 cases (9.5 %), an intra-arterial thrombus developed. Glycoprotein IIb/IIIa inhibitor was administrated in 45 of them who required a rescue treatment. These 45 patients were treated with an intra-arterial bolus (0.2 mg/kg) of eptifibatide. We respectively reviewed the angiographic and clinical outcomes, and the periprocedural complications of the rescue treatment. RESULTS No intra- or early postoperative (48 h) bleeding was observed after treatment. A total recovery of the entire arterial tree (TICI 3) was established in 28 cases (62.2 %), a partial revascularization in 13 cases (28.8 %) (5 TICI 2A and 8 TICI 2B), and no revascularization or reperfusion (TICI 0 or TICI 1) in 4 cases (9 %). Eptifibatide was more effective on proximal obstructions and in-stent occlusions than on peripheral distal thrombus, which were completely disintegrated one time out of three. CONCLUSION Intra-operative intra-arterial use of eptifibatide does not imply an increase of hemorrhagic events. Even if eptifibatide allows for a high rate of arterial recanalization, its effectiveness seems to be less important in cases of distal occlusions.
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Affiliation(s)
- Jacques Sedat
- Unité de Neurointerventionnelle, Hôpital Saint-Roch, 5 rue Pierre Devoluy, Nice, 06000, France,
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Doyen J, Leysalle A, Poudenx M, Otto J, Angellier G, Padovani B, Venissac N, Bondiau PY. Chimioradiothérapie concomitante suivie d’une irradiation stéréotaxique dans les cancers bronchiques non à petite cellules : essai de phase 1 CYBERTAXCIS. Cancer Radiother 2013. [DOI: 10.1016/j.canrad.2013.07.062] [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: 11/30/2022]
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Baqué-Juston M, Mondot L, Leroy S, Padovani B. Multiple lung parenchymal abnormalities: Don't panic, let's be pragmatic! The 6 question rule - a checklist strategy. Diagn Interv Imaging 2013; 95:361-76. [PMID: 24055120 DOI: 10.1016/j.diii.2013.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Indexed: 11/30/2022]
Abstract
Analysis of multiple lung parenchymal abnormalities on HRCT is a real diagnostic challenge. These abnormalities may be due to a disease of the pulmonary interstitial tissue, the bronchial tree, the cardiovascular system or to abnormal alveolar filling with fluid, blood, cells or tumor, several of these etiologies possibly being concomitant. Systematic pathophysiological reasoning, in the form of a logical checklist, guides reflection and covers many of the most frequent diagnoses and potentially treatable emergencies that can be identified by the non-specialist radiologist. This approach also provides a basis for deepening knowledge of each area. The use of the mnemonic FIBROVAKIM (fibrosis-bronchi-vascular-cancer-infection-medication) is easy to apply and summarizes this strategy.
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Affiliation(s)
- M Baqué-Juston
- Radiology Department, Pasteur Hospital, 30, avenue de la Voie-Romaine, Nice cedex 1, France.
| | - L Mondot
- Radiology Department, Pasteur Hospital, 30, avenue de la Voie-Romaine, Nice cedex 1, France
| | - S Leroy
- Respiratory Department, Pasteur Hospital, 30, avenue de la Voie-Romaine, Nice cedex 1, France
| | - B Padovani
- Radiology Department, Pasteur Hospital, 30, avenue de la Voie-Romaine, Nice cedex 1, France
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25
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Bronsard N, Boli T, Challali M, de Dompsure R, Amoretti N, Padovani B, Bruneton G, Fuchs A, de Peretti F. Comparison between percutaneous and traditional fixation of lumbar spine fracture: intraoperative radiation exposure levels and outcomes. Orthop Traumatol Surg Res 2013; 99:162-8. [PMID: 23453915 DOI: 10.1016/j.otsr.2012.12.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 09/25/2012] [Accepted: 12/17/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare radiation exposure doses and clinical and radiological outcomes between percutaneous pedicular screwing (closed reduction internal fixation [CRIF]) and classical open reduction internal fixation (ORIF) in lumbar spine fracture without neurologic deficit. MATERIALS AND METHODS Sixty patients (mean age, 42.5 years) were divided into two treatment groups: (Percutaneous) CRIF versus (traditional) ORIF. Screw position and anatomic vertebral reconstruction were checked on routine control X-ray and postoperative CT scan. Study parameters comprised: surgery time, radiation exposure time, radiation dose level for X-ray (DAP) and for CT (DLP),blood loss, length of hospital stay and postoperative pain (VAS). RESULTS At a mean 25.5 months' follow-up,there were no significant inter-group differences on the epidemiological parameters: age, gender, fracture level, fracture type on the Magerl classification, preoperative local vertebral kyphosis angle, or fracture-to-surgery interval. Effective radiation dose was 3-fold higher in CRIF than in ORIF, but 6-fold lower than for the postoperative CT scan. Postoperative pain on VAS was significantly lower after CRIF, allowing earlier gait resumption and return to work and daily activity. There were no significant differences in length of hospital stay, patient satisfaction, screw malpositioning or postoperative or end-of-follow-up kyphosis angle. CONCLUSION Percutaneous surgery provided clinical and radiological outcomes strictly comparable to those of open surgery, but with a higher effective radiation exposure dose, including for the medical team and especially for the surgeon. This higher exposure dose, however, is to be relativized by comparison to that of the postoperative CT scan, which involved a much higher exposure dose for the patient. LEVEL OF EVIDENCE Level IV. Retrospective study.
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Affiliation(s)
- N Bronsard
- Nice University Hospital Center, Orthopedic and Traumatologic Surgery Department, Hôpital Saint Roch, 5, rue Pierre-Dévoluy, 06000 Nice, France.
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26
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Doyen J, Viard R, Aktaou S, Leysalle A, Poudenx M, Angellier G, Venissac N, Padovani B, Bondiau P. PD-0098: Biological summation of conventional and stereotactic radiation treatment planning in non-small cell lung cancer. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32404-x] [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: 11/26/2022]
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27
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Bronsard N, Serre T, Staccini P, Hovorka I, Thollon L, Padovani B, de Peretti F, Signoli M, Tropiano P. [Biometric and biomechanic analysis of lumbar posterior facets based on a CT-scan database]. Morphologie 2013; 97:19-28. [PMID: 23375579 DOI: 10.1016/j.morpho.2012.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM OF THE STUDY Our knowledge on anatomy of lumbar spine is based on few cadaver's study with old and few subjects. CT-scan is very precise for lumbar facet's morphology. We have analysed 400 subjects. The aim of this study is to measure different distances, angles and circles to better understand the mechanical function of the lumbar facets. PATIENTS AND METHODS We have analysed 720 CT-scan. We had 217 men and 183 women with 59 years of mean age. We used native slices of 1.25 mm thick from L1 to S1. We created transversal plan and we put different mark point. We took their coordinates and we have calculated different distances, angles and mechanical circles. We have compared different axis of rotation of the facets. RESULTS From L1 to S1, the facets goes near to the posterior wall and far from themselves. Moreover, the posterior angle between both facets increase down to the sacrum. The radius of the left side circle and the right one are very closed in 50% of the cases but the three radius are close only in 10% of cases. CONCLUSION This study based on 400 subjects shows that there is not a unique axis of rotation for both lumbar posterior facets. We have had only 50% of symmetry between both sides whatever the level studied.
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Affiliation(s)
- N Bronsard
- Service de chirurgie orthopédique et traumatologique, hôpital Saint-Roch, université de Nice, PC traumatologie 3e étage, ascenseur D, 5, rue Pierre-Dévoluy, 06000 Nice, France.
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Saâda E, Bianchini L, Mouroux J, Dupré F, Butori C, Birtwisle-Peyrottes I, Padovani B, Yver M, Ferrari C, Pedeutour F. First description of inhibition of let-7 microRNA expression and HMGA2 overexpression in a case of deep-seated diffuse lipomatosis. Histopathology 2012; 61:519-22. [PMID: 22642449 DOI: 10.1111/j.1365-2559.2012.04266.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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29
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Giordana P, Baqué-Juston MC, Jeandel PY, Mondot L, Hirlemann J, Padovani B, Raffaelli C. Contrast-enhanced ultrasound of carotid artery wall in Takayasu disease: first evidence of application in diagnosis and monitoring of response to treatment. Circulation 2011; 124:245-7. [PMID: 21747069 DOI: 10.1161/circulationaha.110.006668] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P Giordana
- Unité d’échographie Doppler et exploration vasculaire CHU Pasteur, Nice, France
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30
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Mouroux J, Vénissac N, Pop D, Padovani B, Rigo P. [18-FDG PET-scan of intrathoracic gossypiboma during the monitoring of lung cancer]. Rev Pneumol Clin 2011; 67:154-157. [PMID: 21665078 DOI: 10.1016/j.pneumo.2009.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 10/28/2009] [Accepted: 11/09/2009] [Indexed: 05/30/2023]
Abstract
The 18-FDG PET-scan is today used to monitor patients operated for non small-cell lung cancer. The presence of an intrathoracic gossypiboma (or textiloma) can be responsible for intense enhancement in a PET-scan because of inflammatory phenomenon. The authors report the case of a patient who underwent surgery for lung cancer nine years ago, where a newly discovered intrathoracic mass with intensive enhancement on PET-scan, led to concern about a local recurrence in spite of the fine-needle transthoracic biopsy identifying textile fibers in the histological examination.
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Affiliation(s)
- J Mouroux
- Service de chirurgie thoracique, hôpital Pasteur, avenue de la Voie-Romaine, Nice, France.
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31
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Sauvaget E, Dellamonica J, Arlaud K, Sanfiorenzo C, Bernardin G, Padovani B, Viard L, Dubus JC. Idiopathic acute eosinophilic pneumonia requiring ECMO in a teenager smoking tobacco and cannabis. Pediatr Pulmonol 2010; 45:1246-9. [PMID: 20812251 DOI: 10.1002/ppul.21314] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 05/26/2010] [Accepted: 05/29/2010] [Indexed: 11/10/2022]
Abstract
We describe what we believe is an entirely novel case of a 15-year-old boy with idiopathic acute eosinophilic pneumonia and unusual, resistant hypoxemia which necessitated extracorporeal membrane oxygenation. Response to corticosteroids was excellent and a full recovery was observed. Smoking cigarettes and cannabis on the day the symptoms began may have contributed to the occurrence of this rare disease.
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Affiliation(s)
- Emilie Sauvaget
- Pediatric Pulmonology Unit, University Hospital La Timone-Enfants, Marseille, France
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32
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Hofman V, Dhouibi A, Butori C, Padovani B, Gari-Toussaint M, Garcia-Hermoso D, Baumann M, Vénissac N, Cathomas G, Hofman P. Usefulness of molecular biology performed with formaldehyde-fixed paraffin embedded tissue for the diagnosis of combined pulmonary invasive mucormycosis and aspergillosis in an immunocompromised patient. Diagn Pathol 2010; 5:1. [PMID: 20205795 PMCID: PMC2823679 DOI: 10.1186/1746-1596-5-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [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: 10/29/2009] [Accepted: 01/08/2010] [Indexed: 11/15/2022] Open
Abstract
Immunocompromised patients who develop invasive filamentous mycotic infections can be efficiently treated if rapid identification of the causative fungus is obtained. We report a case of fatal necrotic pneumonia caused by combined pulmonary invasive mucormycosis and aspergillosis in a 66 year-old renal transplant recipient. Aspergillus was first identified during the course of the disease by cytological examination and culture (A. fumigatus) of bronchoalveolar fluid. Hyphae of Mucorales (Rhizopus microsporus) were subsequently identified by culture of a tissue specimen taken from the left inferior pulmonary lobe, which was surgically resected two days before the patient died. Histological analysis of the lung parenchyma showed the association of two different filamentous mycoses for which the morphological features were evocative of aspergillosis and mucormycosis. However, the definitive identification of the associative infection was made by polymerase chain reaction (PCR) performed on deparaffinized tissue sections using specific primers for aspergillosis and mucormycosis. This case demonstrates that discrepancies between histological, cytological and mycological analyses can occur in cases of combined mycotic infection. In this regard, it shows that PCR on selected paraffin blocks is a very powerful method for making or confirming the association of different filamentous mycoses and that this method should be made available to pathology laboratories.
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Affiliation(s)
- Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Louis Pasteur Hospital, 30 avenue de la voie romaine, Nice, France.
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33
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Hugues T, Lemoigne F, Marquette CH, Mouroux J, Padovani B, Gibelin P. [Pulmonary artery compression by a mediastinal tumor]. Ann Cardiol Angeiol (Paris) 2009; 59:172-4. [PMID: 19913214 DOI: 10.1016/j.ancard.2009.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 02/20/2009] [Indexed: 11/30/2022]
Abstract
Acquired arterial pulmonary stenosis is rarely found in adults. Reviews and case reports suggest that tumours of the mediastinum (teratomatas and Hodgkin's disease) are the most frequent culprits leading to compression of the main pulmonary artery. We present the case of a young patient with chest pain. Compression of the main and left pulmonary artery by an anterior mediastinal nonseminomatous germ cell tumors (GCTs) was diagnosed by transthoracic echocardiography and CT scan.
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Affiliation(s)
- T Hugues
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de Voie-Romaine, 06000 Nice, France.
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34
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Padovani B, Ducreux D, Macario S, Maillard M, Iannessi A, Brunner P, Mouroux J. Imagerie du thorax post-opératoire : les aspects normaux. ACTA ACUST UNITED AC 2009; 90:991-1000. [DOI: 10.1016/s0221-0363(09)73237-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Padovani B. [The role of multislice computed tomography in assessment of tumoral extension in lung cancer]. Rev Pneumol Clin 2008; 64:239-244. [PMID: 18995153 DOI: 10.1016/j.pneumo.2008.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 07/07/2008] [Indexed: 05/27/2023]
Affiliation(s)
- B Padovani
- Service d'imagerie médicale, hôpital Pasteur, CHU, 30, avenue de la Voie-Romaine, BP 69, 06002 Nice cedex, France.
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36
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Castelli J, Thariat J, Benezery K, Padovani B, Ducreux D, Venissac N, Poudenx M, Otto J, Mouroux J, Bondiau PY. [Feasibility and efficacy of cyberknife radiotherapy for lung cancer: early results]. Cancer Radiother 2008; 12:793-9. [PMID: 18706844 DOI: 10.1016/j.canrad.2008.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 06/03/2008] [Accepted: 06/08/2008] [Indexed: 12/25/2022]
Abstract
PURPOSE High-dose robotic stereotactic irradiation can be achieved with high precision using the CyberknifeM system equipped with the Synchrony respiratory tracking device. Cyberknife irradiation can overcome some limitations of conventional radiotherapy including errors due to breathing motion and patient setup. High dose levels are of interest for tumours that have shown a dose-response relationship including lung tumours. We reviewed the treatments and outcomes for the first French patients with lung tumours treated at the Cyberknife centre of Nice. PATIENTS AND METHODS Thirty four patients were treated between November 2006 and November 2007 at the Cyberknife centre of Nice, Centre Lacassagne, France. Thirty had untreated primary lung cancer, 4 had colorectal metastasis to the lung. We evaluated the feasibility and reliability of fiducial placement, toxicity and early outcomes. Objective tumour response was assessed on thoracic CT scan every three months. RESULTS There was no grade 3-4 toxicity. Toxicity (11%) mainly consisted of grade 1-2 asthenia. Crude overall tumour response rate was 96% for all assessable patients and 91% at 3 and 6 months, respectively. The use of one fiducial ensured minimal toxicity (no grade III pneumothorax) while allowing reliable tumour tracking as shown by the low infield failure rate (no geographic miss). Diagnostic procedure was performed during fiducial placement when required. CONCLUSION Early toxicity and tumour control rates from this population suggest that the use of a unique fiducial for a Cyberknife treatment was safe and effective for the treatment of selected primary and secondary lung tumours. This strategy is corroborated by similar control rates in the literature. Longer follow-up are awaited.
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Affiliation(s)
- J Castelli
- Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France.
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37
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Benchetritt M, Hofman V, Vénissac N, Brennetot C, Italiano A, Aurias A, Padovani B, Pedeutour F, Hofman P. Dedifferentiated liposarcoma of the pleura mimicking a malignant solitary fibrous tumor and associated with dedifferentiated liposarcoma of the mediastinum: usefulness of cytogenetic and molecular genetic analyses. ACTA ACUST UNITED AC 2008; 179:150-5. [PMID: 18036404 DOI: 10.1016/j.cancergencyto.2007.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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: 07/16/2007] [Revised: 09/04/2007] [Accepted: 09/05/2007] [Indexed: 12/30/2022]
Abstract
Dedifferentiated liposarcoma of the pleura is an extremely rare malignancy mimicking a variety of tumors, such as other sarcomas, mesothelioma, and malignant solitary fibrous tumor of the pleura. Liposarcoma of the pleura can be combined with mediastinal involvement, and in most cases it may be impossible to be certain where the primary tumor originated. In this report, we describe a very rare occurence of a dedifferentiated liposarcoma of the pleura in a 76-year-old woman associated with a distinct second dedifferentiated liposarcoma of the mediastinum. Histologically, the pleural tumor demonstrated spindle cells arranged in a fascicular pattern, whereas the mediastinal tumor was mostly adipocytic with small areas of spindle cells. Vimentin and protein S100 were focally expressed by the tumor cells. The differential diagnosis of the pleural mass included malignant solitary fibrous tumor. Cytogenetic analysis showed supernumerary ring chromosomes in the pleural tumor, as well as strong amplification of MDM2 and CDK4 genes in both tumors. Array comparative genomic hybridization showed amplifications of chromosome arms 6q, 12q, and 15q, shared by both tumors and strongly pointing to a common origin.
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Affiliation(s)
- Maxime Benchetritt
- Laboratory of Clinical and Experimental Pathology, 30 avenue de la voie romaine, Louis Pasteur Hospital, 06002, Nice, France
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Perrin C, Jullien V, Vénissac N, Berthier F, Padovani B, Guillot F, Coussement A, Mouroux J. Prophylactic use of noninvasive ventilation in patients undergoing lung resectional surgery. Respir Med 2007; 101:1572-8. [PMID: 17257820 DOI: 10.1016/j.rmed.2006.12.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2006] [Revised: 11/27/2006] [Accepted: 12/03/2006] [Indexed: 11/18/2022]
Abstract
QUESTION OF THE STUDY We studied whether prophylactic use of noninvasive pressure support ventilation (NIPSV) administered pre- and postoperatively may reduce the postoperative pulmonary function impairment. PATIENTS AND METHODS Prospective randomized clinical trial. Thirty-nine patients with a preoperative FEV(1) <70% of the predicted value scheduled for elective lobectomy related to lung cancer were enrolled. Seven patients were excluded after enrollment. Patients were required to follow standard treatment without (control group, n=18) or with NIPSV (study group, n=14) during 7 days at home before surgery, and during 3 days postoperatively. Primary outcome variable was the changes on arterial blood gases on room air. RESULTS Two hours after surgery, PaO(2), FVC and FEV(1) values were significantly better in the NIPSV group. On day 1, 2 and 3, PaO(2) was significantly improved in the NIPSV group. Also on day 1, FVC and FEV(1) improved significantly in the NIPSV group. The hospital stay was significantly longer in the control group than in the study group (p=0.04). The incidence of major atelectasis was 14.2% in the NIPSV group and 38.9% in the no-NIPSV group (p=0.15). ANSWER TO THE QUESTION: Prophylactic use of NIPSV in a pre- and postoperative manner significantly reduces pulmonary dysfunction after lung resection. As a result, recovery of preoperative respiratory function is accelerated.
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Affiliation(s)
- Christophe Perrin
- Service de Pneumologie, Centre Hospitalier et Universitaire de Nice, France.
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Pop D, Venissac N, Perrin C, Leo F, Padovani B, Mouroux J. Extralobar sequestration with anomalous pulmonary artery return or patent ductus arteriosus? J Thorac Cardiovasc Surg 2005; 130:903-4. [PMID: 16153956 DOI: 10.1016/j.jtcvs.2005.02.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2005] [Accepted: 02/08/2005] [Indexed: 10/25/2022]
Affiliation(s)
- Daniel Pop
- Thoracic Surgery Department, Pasteur Hospital, Nice, France.
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Abstract
Mediastinal cystic lymphangiomas are rare tumours. Usually asymptomatic, they can be complicated by a chylopericardium or/and chylothorax. We report a case of a left lesion infiltrating through the supra-aortic vessels complicated with a iatrogenic left chylothorax managed by bilateral video-assisted thoracoscopy at the same time. First, on the right, the chylous inflow was stopped by suturing the thoracic duct; then, on the left, a fenestration was done to confirm the diagnosis and treat the lesion while preserving the adjacent structures.
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Affiliation(s)
- D Pop
- Thoracic Surgery Department, Pasteur Hospital, Nice, France.
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41
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Affiliation(s)
- Daniel Pop
- Thoracic Surgery Department, Pasteur Hospital, Nice, France.
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42
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Baqué P, Chevallier P, Karimdjee Solihi F, Rahili MA, Iannelli A, Benizri EI, Bernard JL, Bereder JM, Oddo F, Padovani B, Gugenheim J, Benchimol D, Bourgeon A. [Colostomy vs self-expanding metallic stents: comparison of the two techniques in acute tumoral left colonic obstruction]. ACTA ACUST UNITED AC 2004; 129:353-8. [PMID: 15297225 DOI: 10.1016/j.anchir.2004.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [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: 12/30/2003] [Accepted: 04/21/2004] [Indexed: 11/26/2022]
Abstract
UNLABELLED Self-expanding metallic stents is an alternative treatment to colostomy that is the treatment of choice in acute tumoral left colonic obstruction. AIM OF THE STUDY To compare morbidity, mortality, length of hospital stay and treatment performed after desobstruction using the two methods. PATIENTS AND METHODS Thirty-three patients admitted for acute obstruction of the left colon were retrospectively separated in two groups depending on the type of intervention performed to treat the obstruction ("colostomy" group: 17 patients and "self-expanding stent group": 16 patients). We studied complications after desobstruction, hospital courses and surgical strategy performed after the acute phase. RESULTS Time between desobstruction and colectomy was shorter in the "self-expanding stent group" than in the "colostomy group" (18.5 days versus 73 days). Age superior than 75 years and colostomy were the two main factors predicting the risk of definitive colostomy (P < 0.05). Global mean hospital stay was longer in the colostomy group (32.7 days versus 19.3 days, P = 0.02). Two perforations and one local recurrence occurred in the "self-expanding stent group". CONCLUSIONS Self-expanding metallic stent can decrease the permanent colostomy rate and the number of interventions. The recurrence rate seems to be theoretically increased with the stenting method. Then, colostomy must be done for patients in curative situation. The self-expanding metallic stent should be used as a palliative care.
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Affiliation(s)
- P Baqué
- Service de chirurgie générale et cancérologie digestive (Pr A. Bourgeon), hopital l'Archet II, 151 route de Saint-Antoine de Ginestière, BP 3079, Nice cedex 3, France.
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Mouroux J, Venissac N, Leo F, Guillot F, Padovani B, Hofman P. Usual and unusual locations of intrathoracic mesothelial cysts. Is endoscopic resection always possible? Eur J Cardiothorac Surg 2003; 24:684-8. [PMID: 14583298 DOI: 10.1016/s1010-7940(03)00505-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Mesothelial intrathoracic cysts are congenital lesions classically located in the anterior cardiophrenic angle (pleuro-pericardial cysts). Locations elsewhere in the thorax are infrequent. The aim of the study was to describe a 10-year, single-institution experience with endoscopic management of mesothelial cysts by video-assisted thoracoscopy (VT) or video-assisted mediastinoscopy (VM), regardless of their location. METHODS From January 1992 to December 2002, 13 patients (four males and nine females, mean age 49.9 years, range 22-75) underwent surgery for a mesothelial cyst. Information on past history, clinical and radiological presentation, indications for surgery, the surgical procedure and postoperative outcome were collected retrospectively and inserted in a dedicated database. A follow-up visit was performed on December 2002 in all of the patients. RESULTS In five patients the cyst was in the right cardio-phrenic angle, in three cases it was in the left cardiophrenic angle. Five cysts were located in the mediastinum (right paratracheal space in two cases, anterior mediastinum in one case, paravertebral mediastinum in two cases). Mean lesion diameter was 7.5 cm (+/-4) x 5 cm (+/-2). Cyst density ranged between 1 and 10 Hounsfield units (HU) in 11 patients. It was respectively 38 and 52 UH in the other two patients. All patients were classed ASA 1 or 2 according to the guidelines of the American Society of Anesthesiologists (ASA). Indications for surgery included the presence of symptoms, uncertain diagnosis, practice of a particular sport or professional activity, and radiological evidence of compression of the superior vena cava (namely for the two paratracheal lesions). Eleven patients were operated on by VT. Two patients with a right paratracheal lesions were operated on by VM. Mean operating time was 60+/-14 min (range 45-80). No postoperative complications were recorded. The mean postoperative stay was 4.3+/-1.2 days (5 days for VT and 2.5 days for VM). Pathology studies confirmed the diagnosis of mesothelial cyst in all cases. CONCLUSIONS Mesothelial cysts have a heterogeneous distribution within the thorax, and nearly 40% are located elsewhere than in the cardiophrenic angle. Endoscopic resection by VT or VM can be proposed as the treatment of choice even for mesothelial cysts in unusual locations.
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Affiliation(s)
- Jérôme Mouroux
- Department of Thoracic Surgery, Pasteur Hospital, University Hospital of Nice, Nice, 30 Avenue de la voie Romaine, B.P. 69, 06002 Nice, France.
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Marcq L, Vandenbos F, Bernard E, Padovani B, Lambert J, Dellamonica P. Abcès cérébraux familiaux menant à la découverte d'une maladie de Rendu Osler. Rev Med Interne 2003. [DOI: 10.1016/s0248-8663(03)80177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
We report two cases of Morgagni hernia associated with pectus carinatum. This association is exceptional; only two other cases have been reported so far. In one of our patients, an abdominal surgical approach was used to repair the Morgagni hernia and to perform a Nissen-Rossetti procedure (for an associated endobrachyesophagus); the patient did not require correction of the pectus carinatum. In the other patient, both thoracic deformity and Morgagni hernia were repaired using the same thoracic approach.
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Affiliation(s)
- J Mouroux
- Service de Chirurgie Thoracique, Hôpital Pasteur, C.H.U. de Nice, France
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Chevallier P, Peten E, Souci J, Chau Y, Padovani B, Bruneton JN. Detection of portal venous gas on sonography, but not on CT. Eur Radiol 2002; 12:1175-8. [PMID: 11976864 DOI: 10.1007/s00330-001-1144-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [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: 02/07/2001] [Revised: 08/06/2001] [Accepted: 08/27/2001] [Indexed: 10/28/2022]
Abstract
We report three cases of portal venous gas detected on sonography without any portal abnormality on CT. In such a situation portal gas could correspond to a tiny amount of intraluminal gas after blunt abdominal trauma or, in contrast, to large or very large quantities of high blood-solubility gases in case of septicemia. Outcome was favorable in all three cases.
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Affiliation(s)
- Patrick Chevallier
- Department of Radiology, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet II, 151 route de Saint Antoine de Ginestière, BP 3079, 06202 Nice, France.
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Chevallier P, Baqué P, Benchimol D, Bernard J, Souci J, Chevallier A, Bourgeon A, Padovani B. [Treatement of colorectal obstruction with self-expanding metallic stents under fluoroscopic guidance]. J Radiol 2002; 83:473-7. [PMID: 12045744] [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] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
PURPOSE To prospectively evaluate fluoroscopic-assisted insertion of self-expanding metallic stents before surgery or for palliative treatment of soft tissue colorectal obstruction. Materials and methods. From January 1999 to October 2000, 18 consecutive patients with colorectal obstruction were included in the study. Treatment with self-expanding metallic stent was either the first line of treatment before surgery (n=8) (group I) or purely palliative (n=10) (group II). Colic stenosis was located proximal to the sigmoid in seven cases. RESULTS Technical success was achieved in 83.3% of cases and colic decompression was observed after 48 hours in all patients with a stent. Thirty days mortality and stent related complications were respectively 0% and 37.5% for group I, and 20% and 50% for group II. All complications were minor except for one colic perforation by a guidewire. CONCLUSION Stent insertion was effective and provided relief of colic obstruction in the majority of cases. Randomized studies would be necessary to demonstrate a definitive reduction in mortality and morbidity with this technique as compared to the classical surgical approach.
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Affiliation(s)
- P Chevallier
- Service d'Imagerie Médicale, Hôpital Archet II, 151 route e Saint Antoine de Ginestière, BP 3079, 06202 Nice Cedex 3, France.
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Chevallier P, Marcy PY, Francois E, Peten EP, Motamedi JP, Padovani B, Bruneton JN. Controlled transperitoneal percutaneous cecostomy as a therapeutic alternative to the endoscopic decompression for Ogilvie's syndrome. Am J Gastroenterol 2002; 97:471-4. [PMID: 11866290 DOI: 10.1111/j.1572-0241.2002.05457.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Acute colonic pseudo-obstruction, the so-called Ogilvie's syndrome, results in massive colonic dilation without mechanical obstruction. In most cases, a conservative treatment with or without endoscopic decompression is sufficient. In rare cases of relapses or failures, a cecostomy has to be performed. A surgical cecostomy is associated with high morbidity and mortality. However, a percutaneous cecostomy could be an interesting alternative treatment. We report the case of a 67-yr-old male with colonic pseudoobstruction for which both the conservative and the endoscopic treatments were unsuccessful. A percutaneous cecostomy was performed, and for the first time in this indication, a transperitoneal access was used with the help of nylon T-fasteners.
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Affiliation(s)
- Patrick Chevallier
- Department of Radiology, Centre Hospitalier Régional et Universitaire de Nice, Hĵpital Archet II, France
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Boisseau N, Rabary O, Padovani B, Staccini P, Mouroux J, Grimaud D, Raucoules-Aimé M. Improvement of 'dynamic analgesia' does not decrease atelectasis after thoracotomy. Br J Anaesth 2001; 87:564-9. [PMID: 11878725 DOI: 10.1093/bja/87.4.564] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is still controversy concerning the beneficial aspects of 'dynamic analgesia' (i.e. pain while coughing or moving) on the reduction of postoperative atelectasis. In this study, we tested the hypothesis that thoracic epidural analgesia (TEA) prevents these abnormalities as opposed to multimodal analgesia with i.v. patient controlled analgesia (i.v. PCA) after thoracotomy. Fifty-four patients undergoing thoracotomy (lung cancer) were randomly assigned to one of the two groups. Clinical respiratory characteristics, arterial blood gas, and pulmonary function tests (forced vital capacity and forced expiratory volume in 1 s) were obtained before surgery and on the next 3 postoperative days. Atelectasis was compared between the two groups by performing computed tomography (CT) scan of the chest at day 3. Postoperative respiratory function and arterial blood gas values were reduced compared with preoperative values (mean (SD) FEV1 day 0: 1.1 (0.3) litre; 1.3 (0.4) litre) but there was no significant difference between groups at any time. PCA and TEA provided a good level of analgesia at rest (VAS day 0: 21 (15/100); 8 (9/100)), but TEA was more effective for analgesia during mobilization (VAS day 0: 52 (3/100); 25 (17/100)). CT scans revealed comparable amounts of atelectasis (expressed as a percentage of total lung volume) in the TEA (7.1 (2.8)%) and in the i.v. PCA group (6.71 (3.2)%). There was no statistical difference in the number of patients presenting with at least one atelectasis of various types (lamellar, plate, segmental, lobar).
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Affiliation(s)
- N Boisseau
- Department of Anesthesiology, Nice School of Medecine, University of Nice-Sophia Antipolis, Hĵpital Pasteur, CHU de Nice, France
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Chevallier P, Pellegrino C, Bernard JL, Chevallier A, Souci J, Padovani B. [Fluid-fluid level in a non functioning and hemorragic neuro-endocrine islet-cell tumor of the pancreas: MRI features]. J Radiol 2001; 82:1009-11. [PMID: 11591931] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The authors report the MR features of a non functioning and hemorragic islet-cell tumor of the pancreas. This tumor was composed of a central cystic component with a fluid-fluid level seen on T1- and T2-weighted images and a peripheral hypervascular soft tissue component which showed hyperintensity on T2-weighted images with fat saturation.
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Affiliation(s)
- P Chevallier
- Service d'Imagerie médicale, CHRU de Nice, Hôpital Archet II, Nice, France.
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