Rôle de la tomographie d'émission de positions en cancérologie oto-rhino-laryngologique

Contexte : Définir quel a été l apport de la TEP au 18F-FDG au CHU de Lille en oncologie cervico-faciale, depuis sa mise en service (Avril 2009) jusqu à mai 2011. Méthode : Soixante-dix patients adressés pour un examen TEP au 18F-FDG au CHU de Lille pour le bilan carcinologique de tumeurs cervico-faciales ont été étudiés rétrospectivement. Il y avait 25 patients adressés pour bilan d extension initial, 23 patients pour bilan d une adénopathie cervicale prévalente, 14 patients pour suivi postthérapeutique, 6 patients pour bilan d extension d un carcinome indifférencié du nasopharynx et 2 mélanomes de localisation ORL. Les examens ont été réalisés sur une morpho TEP Discovery RX HD 16 (General Electric Medical Systems, FWMH 4 mm). Résultats : Dans le bilan d extension initial, la TEP au 18F-FDG a été très intéressante dans la détection des adénopathies cervicales et surtout des localisations à distance ; dans le bilan d une adénopathie cervicale sans primitif connu la TEP a été performante dans la recherche de la tumeur primitive et des localisations à distance. La TEP a aussi montré son intérêt dans le suivi du mélanome pour les deux patients étudiés dans cette indication. Dans le bilan d un UCNT, la TEP par son excellente valeur prédictive négative et sa forte sensibilité à détecter des lésions à distance représente ici un examen très contributif. Enfin dans le suivi post-thérapeutique la TEP et l imagerie morphologique apparaissent complémentaires. Conclusion : Dans les 5 indications étudiées, la TEP au 18F-FDG a montré son utilité particulièrement dans la détection des lésions à distance, des adénopathies cervicales et également des tumeurs primitives non connues. L imagerie quantitative et aussi l arrivée des nouveaux traceurs pourraient encore en améliorer les performances.LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Evaluation de la radioimmunothérapie en traitement initial des lymphomes folliculaires

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Intérêt de la tomographie par émission de positions au [18 F]-fluorodesoxyglucose dans l'évaluation de la réponse thérapeutique après radiochimiothérapie des cancers de l'oesophage

LILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Facteurs prédictifs en imagerie métabolique de la réponse à la radioimmunothérapie dans le lymphome non hodgkinien

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Scintigraphie parathyroïdienne à l'Hôpital Huriez (10 ans d'éxpérience)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Détermination des volumes fonctionnels des tumeurs en tomographie d'émission de positons

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Le ganglion sentinelle dans le mélanome et le cancer du sein (expérience au C.H.R.U. de Lille)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Nuclear medicine for photodynamic therapy in cancer: planning, monitoring and nuclear PDT

International audiencePhotodynamic therapy (PDT) is a modality with promising results for the treatment of various cancers. PDT is increasingly included in the standard of care for different pathologies. This therapy relies on the effects of light delivered to photosensitized cells. At different stages of delivery, PDT requires imaging toplan, evaluate and monitor treatment. The contribution of molecular imaging in this context is important and continues to increase. In this article, we review the contribution of nuclear medicine imaging in oncology to PDT for planning and therapeutic monitoring purposes. Several solutions have been proposed to plan PDT from nuclear medicine imaging. For instance, photosensitizer biodistribution has been evaluated with aradiolabeled photosensitizer or with conventionalradiopharmaceuticals on positron emission tomography. The effects of PDT delivery have also been explored with specific SPECT or PET radiopharmaceuticals to evaluate the effects on cells (apoptosis, necrosis, proliferation, metabolism) or vascular damage. Finally, the synergy between photosensitizers and radiopharmaceuticals has been studied considering the Cerenkov effect to activate photosensitized cells

A 3D convolutional neural network to classify subjects as Alzheimer's disease, frontotemporal dementia or healthy controls using brain 18F-FDG PET

With the arrival of disease-modifying drugs, neurodegenerative diseases will require an accurate diagnosis for optimal treatment. Convolutional neural networks are powerful deep learning techniques that can provide great help to physicians in image analysis. The purpose of this study is to introduce and validate a 3D neural network for classification of Alzheimer's disease (AD), frontotemporal dementia (FTD) or cognitively normal (CN) subjects based on brain glucose metabolism. Retrospective [18F]-FDG-PET scans of 199 CE, 192 FTD and 200 CN subjects were collected from our local database, Alzheimer's disease and frontotemporal lobar degeneration neuroimaging initiatives. Training and test sets were created using randomization on a 90 %-10 % basis, and training of a 3D VGG16-like neural network was performed using data augmentation and cross-validation. Performance was compared to clinical interpretation by three specialists in the independent test set. Regions determining classification were identified in an occlusion experiment and Gradient-weighted Class Activation Mapping. Test set subjects were age- and sex-matched across categories. The model achieved an overall 89.8 % accuracy in predicting the class of test scans. Areas under the ROC curves were 93.3 % for AD, 95.3 % for FTD, and 99.9 % for CN. The physicians' consensus showed a 69.5 % accuracy, and there was substantial agreement between them (kappa = 0.61, 95 % CI: 0.49–0.73). To our knowledge, this is the first study to introduce a deep learning model able to discriminate AD and FTD based on [18F]-FDG PET scans, and to isolate CN subjects with excellent accuracy. These initial results are promising and hint at the potential for generalization to data from other centers

Repetitive 18 F-FDG-PET/CT in patients with large-vessel giant-cell arteritis and controlled disease

International audienceOBJECTIVE:18F-FDG PET/CT can detect large-vessel involvement in giant-cell arteritis (GCA) with a good sensitivity. In patients with clinically and biologically controlled disease, we aimed to assess how vascular uptakes evolve on repetitive FDG-PET/CT.PATIENTS AND METHODS:All included patients had to satisfy the 4 following criteria: 1) diagnosis of GCA was retained according to the criteria of the American College of Rheumatology or based on the satisfaction of 2 criteria associated with the demonstration of large-vessel involvement on FDG-PET/CT; 2) all patients had a positive PET/CT that was performed at diagnosis before treatment or within the first 10 days of treatment; 3) another FDG-PET/CT was performed after at least 3 months of controlled disease without any relapse; 4) patients were followed-up at least for 12 months.RESULTS:Twenty-five patients (17 [68%] women, median age: 69 [65-78]) with large-vessel inflammation on a baseline FDG-PET/CT and with repetitive imaging during the period with controlled disease were included and followed-up for 62 [25-95] months. Four repeated procedures revealed total extinction of vascular uptakes at 11.5 [8-12] months after the first FDG-PET/CT. Eight PET/CT revealed decreased numbers of vascular uptakes, and 10 procedures revealed no changes. The 3 remaining procedures indicated worsening of the numbers of vascular uptakes in the absence of relapse.CONCLUSIONS:Our study revealed long-term persistent vascular uptake on repeated FDG-PET/CT in >80% of our GCA patients with large-vessel inflammation and clinical-biological controlled disease. Prospective studies are required to confirm these findings