Utility of Quantitative 99mTc-MAA SPECT/CT for 90yttrium-Labelled Microsphere Treatment Planning: Calculating Vascularized Hepatic Volume and Dosimetric Approach

Objectives. The aim of this study was to assess the effectiveness of SPECT/CT for volume measurements and to report a case illustrating the major impact of SPECT/CT in calculating the vascularized liver volume and dosimetry prior to injecting radiolabelled yttrium-90 microspheres (Therasphere). Materials and Methods. This was a phantom study, involving volume measurements carried out by two operators using SPECT and SPECT/CT images. The percentage of error for each method was calculated, and interobserver reproducibility was evaluated. A treatment using Therasphere was planned in a patient with three hepatic arteries, and the quantitative analysis of SPECT/CT for this patient is provided. Results. SPECT/CT volume measurements proved to be accurate (mean error <6% for volumes ≥16 cm3) and reproductive (interobserver agreement = 0.9). In the case report, 99mTc-MAA SPECT/CT identified a large liver volume, not previously identified with angiography, which was shown to be vascularized after selective MAA injection into an arterial branch, resulting in a large modification in the activity of Therasphere used. Conclusions. MAA SPECT/CT is accurate for vascularized liver volume measurements, providing a valuable contribution to the therapeutic planning of patients with complex hepatic vascularization

L'aliment idéal existe-t-il ? Questions d'aujourd'hui sur l'alimentation de demain

National audienceEn réponse à la question "l'aliment idéal existe-t-il ?", il paraît justifié d'évoquer un idéal de l'aliment qui évolue avec la société. Si hier réussir à se nourrir suffisamment constituait cet idéal, aujourd'hui celui-ci s'oriente davantage vers la quête de plaisir, étayée d'attentes en matière de santé, de sécurité, de praticité tout en conservant la tradition, la culture et la part de rêve de chacun. Cette métamorphose est subordonnée aux évolutions scientifique et technologique. Cependant le consommateur a aujourd'hui du mal à concevoir une alimentation associant qualité gustative et production de masse d'autant qu'il est encore réticent à l'idée de payer cette qualité ainsi qu'à l'idée d'une science trop interventionniste

High prognostic value of 18F-FDG PET for metastatic gastroenteropancreatic neuroendocrine tumors: a long-term evaluation.

International audienceThis study aimed to evaluate the long-term prognostic usefulness of (18)F-FDG PET for patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEPNETs). Thirty-eight patients with metastatic GEPNETs were prospectively enrolled. Initial check-up comprised CT scan, (111)In-pentetreotide scintigraphy (SRS), and (18)F-FDG PET. Only (18)F-FDG PET-positive lesions with a maximum standardized uptake value (SUVmax) greater than 4.5 or an SUV ratio (SUVmax tumor to SUVmax nontumoral liver tissue, or T/NT ratio) of 2.5 or greater were considered positive for prognosis-that is, indicating a poor prognosis. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Factors associated with survival were assessed with univariate and multivariate analyses, using the Cox regression model. Median PFS and OS were significantly higher for patients with a negative (18)F-FDG PET finding, with an OS of 119.5 mo (95% confidence interval [CI], 72-∞), than for patients with a positive (18)F-FDG PET finding (only 15 mo [95% CI, 4-27]) (P < 10(-3)). Median PFS and OS were significantly higher for the patient group that had a positive SRS than the group with a negative SRS (P = 0.0002). For patients with a positive SRS, PFS and OS were significantly shorter when the (18)F-FDG PET finding was positive: 19.5 mo (95% CI, 4-37) for PFS and 119.5 mo (95% CI, 81-∞) for OS (P < 10(-3)). In the patient group with a low-grade GEPNET and a positive SRS, PFS and OS were also significantly lower for patients with a positive (18)F-FDG PET. At 48-mo follow-up, 100% of patients who had a positive (18)F-FDG PET for disease progression (of which 47% were also SRS-positive) were deceased, and 87% of patients with a negative (18)F-FDG PET were alive (P < 0.0001). The T/NT ratio was the only parameter associated with OS on multivariate analysis. Overall, (18)F-FDG PET appears to be of major importance in the prognostic evaluation of metastatic GEPNET. A positive (18)F-FDG PET with an SUV ratio (T/NT) of 2.5 or greater was a poor prognostic factor, with a 4-y survival rate of 0%. A positive SRS does not eliminate the need for performing (18)F-FDG PET, which is of greater prognostic utility

Overview Of Materials Research And Ifmif/Eveda Under The Broader Approach Framework

In parallel to the ITER program, the Broader Approach (BA) activities with three projects are being implemented by the European Union (EU) and Japan. Five research and development (R&D) tasks, mainly on blanket-related materials, are being carried out as the DEMO R&D program in the BA to establish key technologies required for the DEMO engineering design. The DEMO R&D building was constructed in March 2010, and the installation of research equipment was completed in March 2011. As the BA DEMO R&D, fabrication technology and/or characterization of reduced activation ferritic/martensitic steels, SiC/SiC composites, and the advanced neutron multiplier and advanced tritium breeder have progressed in Japan and the EU. In the Inter-national Fusion Materials Irradiation Facility (IFMIF)/Engineering Design and Engineering Validation Activities (EVEDA) project, engineering design and validations have progressed. The injector of the IFMIF prototype accelerator produced first beam successfully in May 2011 and will be delivered to the Rokkasho BA site in 2012. The commissioning of the EVEDA lithium test loop was completed in March 2011, and a lithium flow of 25 film thick at similar to 5 m/s was obtained