146 research outputs found
Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging
The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution post-contrast images acquired at 2min ± 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph node-specific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cance
Staging of endometrial cancer with MRI: guidelines of the european society of urogenital imaging
The purpose of this study
was to define guidelines for endometrial
cancer staging with MRI. The
technique included critical review and
expert consensus of MRI protocols by the female imaging subcommittee of
the European Society of Urogenital
Radiology, from ten European institutions,
and published literature between
1999 and 2008. The results
indicated that high field MRI should
include at least two T2-weighted
sequences in sagittal, axial oblique or
coronal oblique orientation (short and
long axis of the uterine body) of the
pelvic content. High-resolution postcontrast
images acquired at 2 min ± 30 s
after intravenous contrast injection
are suggested to be optimal for the
diagnosis of myometrial invasion. If
cervical invasion is suspected, additional
slice orientation perpendicular
to the axis of the endocervical channel
is recommended. Due to the limited
sensitivity of MRI to detect lymph
node metastasis without lymph nodespecific
contrast agents, retroperitoneal
lymph node screening with
pre-contrast sequences up to the level
of the kidneys is optional. The likelihood
of lymph node invasion and
the need for staging lymphadenectomy
are also indicated by high-grade histology
at endometrial tissue sampling
and by deep myometrial or cervical
invasion detected by MRI. In conclusion,
expert consensus and literature
review lead to an optimized MRI
protocol to stage endometrial cancer
High intensity linac driver for the SPIRAL-2 project : Design of superconducting 88 MHz quarter wave resonators (beta 0.12), power couplers and cryomodules
ACCInternational audienceA Superconducting Linac Driver, delivering deuterons with energy up to 40 MeV (5 mA) and heavy ions with energy of 14.5 MeV/u (1 mA ), is proposed for the Spiral-2 radioactive beams facility. For the high energy section of the linac, a superconducting 88 MHz Quarter Wave Resonator (beta 0.12) has been designed and the optimisation of RF and mechanical performances will be presented. Based on the present state-of-art of the Superconducting RF technology, maximum electric surface field of 40 MV/m and magnetic surface field of 80 mT, have been adopted which should allow to reach an accelerating field of 7 MV/m (energy gain 3 MeV per resonator). A first complete prototype is under construction. The high intensity deuteron beam specifications have imposed the design of an original power coupler (maximum power 20 KW). The RF, mechanical, and thermal characteristics will be presented. The design of the cryomodule for this high energy section, integrating two QWR with its associated equipments (couplers, tuners, helium tanks), will be presented
Staging of uterine cervical cancer with MRI: guidelines of the european society of urogenital radiology
Objective: To design clear guidelines for the
staging and follow-up of patients with uterine cervical
cancer, and to provide the radiologist with a framework for
use in multidisciplinary conferences. Methods: Guidelines
for uterine cervical cancer staging and follow-up were
defined by the female imaging subcommittee of the ESUR
(European Society of Urogenital Radiology) based on the
expert consensus of imaging protocols of 11 leading
institutions and a critical review of the literature. Results:
The results indicated that high field Magnetic Resonance
Imaging (MRI) should include at least two T2-weighted
sequences in sagittal, axial oblique or coronal obliqu
62 – Validation d’une signature transcriptomique (EHT Dx14) sur des échantillons de tumeurs mammaires prélevés par cytoponction à l’aiguille fine
Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) score for risk stratification of sonographically indeterminate adnexal masses.
Importance: Approximately one-quarter of adnexal masses detected at ultrasonography are indeterminate for benignity or malignancy, posing a substantial clinical dilemma. Objective: To validate the accuracy of a 5-point Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) score for risk stratification of adnexal masses. Design, Setting, and Participants: This multicenter cohort study was conducted between March 1, 2013, and March 31, 2016. Among patients undergoing expectant management, 2-year follow-up data were completed by March 31, 2018. A routine pelvic MRI was performed among consecutive patients referred to characterize a sonographically indeterminate adnexal mass according to routine diagnostic practice at 15 referral centers. The MRI score was prospectively applied by 2 onsite readers and by 1 reader masked to clinical and ultrasonographic data. Data analysis was conducted between April and November 2018. Main Outcomes and Measures: The primary end point was the joint analysis of true-negative and false-negative rates according to the MRI score compared with the reference standard (ie, histology or 2-year follow-up). Results: A total of 1340 women (mean [range] age, 49 [18-96] years) were enrolled. Of 1194 evaluable women, 1130 (94.6%) had a pelvic mass on MRI with a reference standard (surgery, 768 [67.9%]; 2-year follow-up, 362 [32.1%]). A total of 203 patients (18.0%) had at least 1 malignant adnexal or nonadnexal pelvic mass. No invasive cancer was assigned a score of 2. Positive likelihood ratios were 0.01 for score 2, 0.27 for score 3, 4.42 for score 4, and 38.81 for score 5. Area under the receiver operating characteristic curve was 0.961 (95% CI, 0.948-0.971) among experienced readers, with a sensitivity of 0.93 (95% CI, 0.89-0.96; 189 of 203 patients) and a specificity of 0.91 (95% CI, 0.89-0.93; 848 of 927 patients). There was good interrater agreement among both experienced and junior readers (κ = 0.784; 95% CI, 0.743-0824). Of 580 of 1130 women (51.3%) with a mass on MRI and no specific gynecological symptoms, 362 (62.4%) underwent surgery. Of them, 244 (67.4%) had benign lesions and a score of 3 or less. The MRI score correctly reclassified the mass origin as nonadnexal with a sensitivity of 0.99 (95% CI, 0.98-0.99; 1360 of 1372 patients) and a specificity of 0.78 (95% CI, 0.71-0.85; 102 of 130 patients). Conclusions and Relevance: In this study, the O-RADS MRI score was accurate when stratifying the risk of malignancy in adnexal masses
Instrumentation pour le suivi en ligne des traitements par hadronthérapie
National audienceInstrumentation for on-line monitoring of hadrontherapy treatments Localization of the dose deposited in the patient is a key point for the hadrontherapy cancer treatment. Different modalities of on-line control are explored, motivating acquisition systems and detectors developments, such as a Compton gamma camera, a proton trajectometer and a beam hodoscope
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