Imagerie de diffusion Intravoxel Incoherent motion (IVIM) et caractérisation des lésions nodulaires hépatiques

Déterminer l apport de l imagerie de diffusion Intra-Voxel Incoherent Motion (IVIM) en IRM 1,5 Tesla dans la caractérisation des lésions nodulaires hépatiques. 140 lésions hépatiques (10 kystes, 34 angiomes, 14 Hyperplasies Nodulaires Focales (HNF), 3 adénomes, 50 carcinomes hépatocellulaires (CHC), 29 métastases) de plus de 15 mm chez 91 patients ont été explorées en IRM de diffusion (10 facteurs de b : 0, 10, 20, 30, 50, 80, 100, 200, 400 et 800 s/mm2) entre janvier 2008 et mars 2011 et les paramètres IVIM (D le coefficient de diffusion, D* le coefficient de perfusion liée à la diffusion, f la fraction de perfusion et l ADC le coefficient apparent de diffusion) ont été analysés de manière rétrospective et comparés (Mann-Whitney, ROC). Les kystes et les angiomes présentent un ADC et un coefficient de diffusion D significativement plus élevé que celui des tumeurs malignes (p<0,05). Une valeur d ADC de 1,45.10-3mm2/s et un D de 1,28.10-3mm2/s permet de distinguer les tumeurs bénignes des tumeurs malignes avec une Se supérieure 75,4% et une Sp supérieure à 70,6%. La fraction perfusive de la diffusion de l angiome est significativement supérieure à celle du CHC (p<0,05). D* de l HNF est supérieur à celui de l angiome (p<0,005) et du CHC (p=0,052). Les paramètres de diffusion IVIM complètent la caractérisation tumorale hépatique.PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocSudocFranceF

Interactive Multi-Organ Segmentation based on Multiple Template Deformation

International audience<p>We present a new method for the segmentation of multipleorgans (2D or 3D) which enables user inputs for smart contour editing.By extending the work of [1] with user-provided hard constraints thatcan be optimized globally or locally, we propose an efficient and user-friendly solution that ensures consistent feedback to the user interactions.We demonstrate the potential of our approach through a user studywith 10 medical imaging experts, aiming at the correction of 4 organsegmentations in 10 CT volumes.We provide quantitative and qualitativeanalysis of the users' feedback.</p

Parallel Guidewire for Catheter Stabilization in Interventional Radiology: The Anchoring Wire Technique.

This technical note describes the parallel guidewire method: the anchoring technique as a strategy to ease difficult catheterization in various endovascular interventions. Sixteen patients were included in 2017 in whom this technique was used. The type of intervention, the nature of the target and anchored vessels and possible complications on the anchored vessel were reported. This study included thirteen various embolization cases and four visceral vessels angioplasties cases. The success of catheterization by using this technique was achieved in all cases, without complication on the anchored vessels

CBCT-Based Image Guidance for Percutaneous Access: Electromagnetic Navigation Versus 3D Image Fusion with Fluoroscopy Versus Combination of Both Technologies—A Phantom Study

International audienc

Prostatic artery embolisation versus medical treatment in patients with benign prostatic hyperplasia (PARTEM): a randomised, multicentre, open-label, phase 3, superiority trialResearch in context

Summary: Background: Prostatic artery embolisation (PAE) is a minimally invasive treatment of symptomatic benign prostatic hyperplasia (BPH). Our aim was to compare patient's symptoms improvement after PAE and medical treatment. Methods: A randomised, open-label, superiority trial was set in 10 French hospitals. Patients with bothersome lower urinary tract symptoms (LUTS) defined by International Prostatic Symptom Score (IPSS) > 11 and quality of life (QoL) > 3, and BPH ≥50 ml resistant to alpha-blocker monotherapy were randomly assigned (1:1) to PAE or Combined Therapy ([CT], oral dutasteride 0.5 mg/tamsulosin hydrochloride 0.4 mg per day). Randomisation was stratified by centre, IPSS and prostate volume with a minimisation procedure. The primary outcome was the 9-month IPSS change. Primary and safety analysis were done according to the intention-to-treat (ITT) principle among patients with an evaluable primary outcome. ClinicalTrials.gov Identifier: NCT02869971. Findings: Ninety patients were randomised from September 2016 to February 2020, and 44 and 43 patients assessed for primary endpoint in PAE and CT groups, respectively. The 9-month change of IPSS was −10.0 (95% confidence interval [CI]: −11.8 to −8.3) and −5.7 (95% CI: −7.5 to −3.8) in the PAE and CT groups, respectively. This reduction was significantly greater in the PAE group than in the CT group (−4.4 [95% CI: −6.9 to −1.9], p = 0.0008). The IIEF-15 score change was 8.2 (95% CI: 2.9–13.5) and −2.8 (95% CI: −8.4 to 2.8) in the PAE and CT groups, respectively. No treatment-related AE or hospitalisation was noticed. After 9 months, 5 and 18 patients had invasive prostate re-treatment in the PAE and CT group, respectively. Interpretation: In patients with BPH ≥50 ml and bothersome LUTS resistant to alpha-blocker monotherapy, PAE provides more urinary and sexual symptoms benefit than CT up to 24 months. Funding: French Ministry of Health and a complementary grant from Merit Medical