Ms-Multi-Spine challenge proceedings

International audienceThis proceedings book gathers the methodological papers accompanying pipelines submitted for the ms-multi-spine-challenge (https://portal.fli-iam.irisa.fr/MS-Multi-Spine/), that took place in the context of Miccai 2025 conference. This challenge results from the joint motivation of the OFSEP(https://www.ofsep.org/en) (French registry on multiple sclerosis aiming at gathering, for research purposes, imaging data, clinical data and biological samples from the French population of multiple sclerosis subjects), FLI(https://portal.fli-iam.irisa.fr/) (France Life Imaging, devoted to setup a national distributed e-infrastructure to manage and process medical imaging data) and Empenn research team. These particular efforts were directed towards bringing attention to the spinal cord multiple sclerosis lesion segmentation and to its specific methodological setting. Indeed, in clinical practice, it is highly recommended to acquire at least two sequences among a set of available ones for the detection of spinal cords, without specific guidelines to date. In practice, depending on the center and context, any combination of existing MR sequences can be provided. This challenge therefore represents a concrete and paradigmatic case of missing modalities setting where, depending on the case, some modalities may be missing both at inference or training time. To the best of our knowledge, such clinical datasets are still rarely available in medical imaging. More generally, to date, the medical imaging community concentrated its efforts toward the detection/segmentation of the lesions in brain MRI but spinal cord lesions remain a topic much less studied. In this challenge, we provided a set of 100 segmented cases with different combinations of sequences among sagittal T2w, sagittal PSIR, sagittal STIR and 3d MPRAGE to the participants, that were asked to propose a segmentation method being able to deal with any of the following combinations (sagittal T2w, sagittal PSIR), (sagittal T2w, sagittal STIR), (sagittal T2w, 3d MP2RAGE) and (sagittal T2w, sagittal STIR, 3D MP2RAGE). The performances of the methods were then assessed using a dedicated testing set. The training and testing data sets were manually annotated using a principled process involving 5 experts for each case. All pipelines were submitted in the form of a docker and integrated to the VIP platform (creatis.insa-lyon.fr/vip/) and participants were not involved in the evaluation on the test set data. The dataset can be requested at (https://shanoir.irisa.fr/shanoir-ng/welcome) and we hope it will contribute to unlock new solutions to improve spinal cord lesion segmentation methods

Prognosis of essential mixed cryoglobulinemia and connective tissue disease-related cryoglobulinemia after rituximab-induced remission.

International audienceObjectives: Rituximab (RTX) and glucocorticoids are the first line treatment for essential (EM) and connective tissue disease (CTD)-related mixed cryoglobulinemia vasculitis (CryoVas). Data on long term outcomes of these CryoVas are lacking. We aimed to describe the prognosis of patients with EM and CTD-related CryoVas.Methods: We conducted a retrospective study on patients with EM or CTD-related CryoVas in remission after RTX-based therapy.Results: We included 63 patients with a median follow-up of 58 months (IQR, 33-88 months). Relapse rates were 23% at 1 year, 42% at 2 years and 71% at 5 years after the initial flare. In univariate analysis, factors associated with relapse were purpura (HR, 2.2; 95% confidence interval (CI), 1.1-4.4; p = 0.02) and a previous flare of CryoVas (HR, 1.9; 95% CI, 1.0-3.7; p = 0.04). Maintenance therapy was associated with a lower risk of early relapse (HR, 0.3; 95% CI, 0.1-0.9; p = 0.03), but not of late relapse (HR, 2.0; 95% CI, 0.7-5.7; p = 0.21). In multivariable analysis, patients without purpura or previous flare remained at lower risk of relapse than those with at least one of the two (HR, 3.6; 95%CI, 1.6-8.2; p= 0.002). Maintenance regimen was associated with a lower risk of early relapse (HR, 0.3; 95% CI, 0.1-0.9; p = 0.03).Conclusion: In patients with EM and CTD-related CryoVas who received RTX as induction therapy, relapses were frequent and associated with purpura and a previous flare, but were reduced with maintenance therapy

Validation of an 8-item self-administered questionnaire for assessing migraine-related sensory hypersensitivities (MHQ-8)

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DiCART TM device to measure capillary refill time: a validation study in patients with acute circulatory failure

International audienceCapillary Refill Time (CRT) is a valuable metric to assess cutaneous perfusion. Its prognostic value in patients with acute circulatory failure has been reported as improved when the measurement is standardized. The DiCART™ device is a fully automated CRT measurement tool requiring validation. We conducted a comparative interventional single-center study including 25 patients with acute circulatory failure, to evaluate the agreement between CRT measured by an automated measurement device (CRTDiCART) and CRT measured clinically (CRTCLIN). CRT was measured on the fingertip, chest, and knee. Three measurements were performed at each location to obtain an average for each site. The measurements were conducted both clinically and using the DiCART™ device by two different operators, each blinded to the results. Agreement was determined using intraclass correlation coefficient (ICC) and Bland and Altman analysis. The ICC between CRTCLIN and CRTDiCART was 0.46 (95% Confidence Interval (CI) 0.32, 0.59) across all measurement sites; the mean bias was 0.23s (95% CI -0.17, 0.64), with upper Limit of Agreement (LoA) 2.77s (95% CI 2.44, 3.20) and lower LoA - 2.30s (-2.73, -1.97). Intra observer ICC was 0.85 (95% CI 0.74, 0.91) for CRTCLIN and 0.43 (95% CI 0.15, 0.64) for CRTDICART. Inter observer ICC was 0.86 (95% CI 0.76, 0.92) for CRTCLIN and was 0.41 (95% CI 0.14, 0,63) for CRTDICART. The DiCART™ device showed poor agreement with clinical CRT in patients with acute circulatory failure, which does not support its use in routine practice

HERV-derived epitopes represent new targets for T-cell-based immunotherapies in ovarian cancer

International audienceBackground Ovarian cancer represents the most lethal gynecological cancer with poor response to checkpoint inhibitors. Human endogenous retroviruses (HERVs) are aberrantly expressed by tumor cells and may represent a source of shared T-cell epitopes for cancer immunotherapy regardless of the tumor mutational burden. Methods A transcriptomic analysis based on RNA sequencing was developed to quantify the expression of HERV-K sequences containing the selected epitopes. The presence of HERV-K/HML-2 Gag antigen was then assessed by immunohistochemistry (IHC) on tumor microarrays from ovarian cancer samples and normal ovarian tissues. A specific immunopeptidomics approach was developed to detect epitopes on human leukocyte antigens (HLA) molecules. Epitope-specific CD8 + T cells were quantified by multimer staining. HERV-specific T cells were obtained after in vitro stimulation of T cells from HLA-A2-positive healthy donors or patients with ovarian cancer, and in vitro target cell killing was evaluated using real-time analysis. In vivo antitumor efficacy of HERV-specific T cells was assessed in an avian embryo model. Results Epitope-containing HERV transcripts were significantly higher in ovarian cancers compared with normal tissues. The presence of the HERV-K/HML-2 Gag antigen was confirmed by IHC in 20/40 (50%) ovarian cancers while no Gag expression was found in normal ovarian tissue samples. Immunopeptidomics analysis revealed the presence of epitopes on HLA molecules on the surface of ovarian tumor cell lines but not on normal primary cells from critical tissues. Low percentages of HERV-specific T cells were detected among tumor-infiltrating lymphocytes from ovarian cancers. Furthermore, in vitro stimulation of patient T cells induced functional epitope-specific T cells, confirming the immunogenicity of these epitopes in patients with ovarian cancer. In vitro, HERV-specific T cells specifically killed ovarian cancer cells in an HLA class I-restricted manner while sparing normal HLA-A2-positive primary cells derived from critical tissues. Epitope-specific CD8 + T cells exhibited a strong antitumoral activity in vivo, inducing a highly significant decrease in tumor volume in comparison with control groups. Conclusion These results provide the preclinical rationale for developing T-cell-based approaches against HERV-K-derived epitopes in ovarian cancer

Immunological and Clinical Markers of Post‐acute Sequelae of COVID‐19: Insights from Mild and Severe Cases 6 Months Post‐infection

International audiencePost‐acute sequelae of COVID‐19 (PASC) are a complex clinical condition that requires a better understanding of its underlying biological mechanisms. In this study, we assessed hundreds of virological, serological, immunological, and tissue damage biomarkers in two cohorts of patients who had experienced either mild ( n = 270) or severe ( n = 188) COVID‐19, 6 to 9 months post‐initial infection, and in which 40% and 57.4% of patients, respectively, developed PASC. Blood analysis showed that the main differences observed in humoral, viral, and biological biomarkers were associated with the initial COVID‐19 severity, rather than being specifically linked to PASC. However, patients with PASC displayed altered CD4 + and CD8 + memory T cell subsets, with higher cytokine‐secreting cells and increased terminally differentiated CD45RA + effector memory T cells (TEMRA). Elevated SARS‐CoV‐2‐specific T cells responsive to nucleocapsid/membrane proteins with a TEMRA phenotype were also observed. A random forest model identified these features and initial symptom duration as top variables discriminating PASC, achieving over 80% classification accuracy

Impact of socioeconomic individual and ecological factors on extreme diagnosis-to-treatment interval in diffuse large B-Cell lymphoma in the French real-world cohort REALYSA

International audienceIntroduction: Diffuse large B-cell lymphoma (DLBCL) is an aggressive though potentially curable lymphoid malignancy requiring timely treatment initiation. We investigated the impact of individual socioeconomic status and home area-level (ecological) factors on the diagnosis-to-treatment interval (DTI) in DLBCL patients, focusing on extreme delays in a French real-world cohort (REALYSA).Methods: We analyzed patients with newly diagnosed DLBCL in the multicentric prospective cohort. DTI was defined as a duration in days between diagnosis confirmation and first-line therapy. Short and long DTIs (10th percentiles) were compared to intermediate DTI using multinomial models to identify factors associated with extreme DTIs. Socio-demographic data (including sex, education, employment, marital status, social support (SSQ6-score)…) and ecological characteristics (French deprivation index, local accessibility to general practitioners) were considered.Results: Among 889 newly diagnosed DLBCL patients (median age 66 years, 49 % with aaIPI ≥1, 35 % with B-symptoms, 33 % with bulky disease), median DTI was 25 days (interquartile range: 15-39 days). The 10th- and 90th-percentile for extreme DTIs were < 8 and > 50 days respectively. In multivariable analysis, factors associated with short DTI included aaIPI (OR=3.03, CI95 %[1.44-6.41]), bulky disease (OR=3.06, CI95 %[1.68-5.58]), and B symptoms (OR=2.35, CI95 %[1.30-4.25]) - indicating expedited treatment for aggressive presentations. Conversely, factors associated with long DTI included older age (OR>80 y = 3.31, CI95 %[1.39-7.89]), being a blue-collar worker or farmer (OR=2.36, CI95 %[1.18-4.73]), or changing type of treatment facility between biopsy and initial treatment.Conclusion: In this large real-world cohort of newly diagnosed DLBCL patients, age, occupational status, and patients' pathway were linked to very long delays to treatment. Interventions to streamline DTIs, especially for older and/or blue-collar or farmer patients, and for those changing facility of treatment, are warranted to improve quality of care

Glucagon-Like Peptide-1 Receptor Agonists in Hidradenitis Suppurativa

International audienceThis cohort study investigates the potential therapeutic benefits of glucagon-like peptide-1 receptor agonists in patients with hidradenitis suppurativa

Using machine learning to identify speech markers of subjective cognitive impairment in breast cancer survivors

See also link: Access to full-text view-only.International audiencePurpose: Cancer-related cognitive impairment (CRCI) refers to cognitive changes described by cancer patients. While subjective cognitive difficulties in survivors are well screened by questionnaires, CRCI remains seldom diagnosed by neuropsychological tests. New objective approaches are needed to detect CRCI. The goal of this study is to find the speech markers that can best detect CRCI.Methods: Forty-four women who completed breast cancer treatment and 13 controls were asked to narrate a picture-based story. Speech productions were recorded and analyzed using semi-automatic methods. Fourteen speech features were extracted and incorporated in machine learning models to classify CRCI assessed using the FACT-Cog questionnaire. In addition, all participants underwent psychological assessment to control for confounding factors. Results The combination of speech-to-silence ratio, mean duration of silent pauses, and mean duration of filled pauses best predicted cancer survivors with CRCI (ROC = 0.74, accuracy = 73.7%). Bayesian Generalized Linear Models further showed that silence in participants’ speech depended on whether they had CRCI and reported depression assessed using the HADS. Credibility Intervals of regression coefficients showed only a trend for reported depression (95% CI [− 0.36, − 0.00]), while scores were below clinical thresholds for depressive disorders for all groups. Conclusions Long silent pauses in discourse may be a sign of cancer-related cognitive impairment in survivors of breast cancer.Implications for Cancer Survivors: This study demonstrates the benefits of using speech analysis as a fast, ecological, and non-invasive technique for assessing CRC