Intérêt de la TEP-TDM au 18FDG dans la prise en charge des cancers des voies aéro-digestives supérieures ou VADS (étude rétrospective bordelaise à propos de 112 cas)

BORDEAUX2-BU Santé (330632101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Chimie du saccharose (voie d'accès à des dérivés enrichis en deutérium, à des éthers amphiphiles et à des composés polymérisables)

Le saccharose est le composé organique pur le plus produit dans le monde. Malgré des qualités remarquables (hydrophilie, pureté, biodégradabilité, non-toxicité, provenance de ressource agricoles renouvelables), la quasi-totalité de la production est destinée au secteur de l'agroalimentaire sous une forme non transformée. La synthèse de composés dérivés du saccharose constitue donc un enjeu économique et écologique important. Dans ce but, les méthodes de transformation doivent être respectueuses de l'environnement et d'un coût raisonnable. Les fructo-oligosaccharides (FOS), obtenus par biotransformation du saccharose, sont préparés à l'échelle industrielle et sont commercialisés sous le nom d'Actilight® pour leurs effets comparables à ceux des fibres alimentaires. Dans le but d'étudier le métabolisme des fructo-oligosaccharides, le (6,6,1',1',6',6'-2H6)-saccharose a été synthétisé. Ce produit va permettre l'obtention de fructo-oligosaccharides marqués par des deutériums. Les dérivés tensioactifs du saccharose présentent également un grand intérêt pour l'industrie. Une méthode de préparation d'éthers amphiphiles du saccharose en milieux aqueux a été mise au point. Les facteurs chimiques et physico-chimiques influençant la cinétique de la réaction ont été étudiés. La préparation de monomères hydrophiles, précurseurs des hydrogels, entre également dans le cadre de la valorisation non alimentaire du saccharose. Des alkyl a -D-glucopyranosides fonctionnalisés et polymérisables ont été obtenus à partir de la carboxyméthyl 3,4,6-tri-O-acétyl- a -D-Glucopyranosides 2-O-lactone, obtenue à partit de l'isomaltulose, lui-même produit à l'échelle industrielle en une étape de bioconversion à partir du saccharose.LYON1-BU.Sciences (692662101) / SudocSudocFranceF

024 Validation with thallium 201 of a new cadmium-zinc-telluride (CZT) cardiac camera

BackgroundNovel dedicated ultrafast cardiac cameras had recently be introduced to improve myocardial perfusion imaging.ObjectivesWe report the first validation study with thallium-201 and the new GE Discovery NM 530c CZT cardiac camera.MethodsWe prospectively studied with thallium-201 153 consecutive patients referred for myocardial perfusion imaging at exercise (111 to 148MBq) then redistribution (with a 37MBq reinjection).We performed sequential acquisitions, first with conventional dual head tomographic Anger camera (CC) in 11 to 16mn, then with CZT camera (CZT) in 5mn, in prone then in supine position.Results– we excluded 7 patients: 1 for mispositionning, 1 for camera failure, 1 for too late acquisition after exercise, 1 for non acceptation of redistribution by the patient, 1 for motion of the patient.– acquisition was more comfortable with CZT for all patients.– counts rate was 3 times more with CZT than with CC (3.5 to 5KCts/s vs 1 to 1.5).– myocardial counts rate was 6 to 8 times more with CZT than with CC.– comparison between CZT and CC: quality of CZT images was considered as better in 38%, equal in 59% and worse in 3% of cases; diagnostic conclusions were the same in 137 of 146 cases (94%); discordances were 2 artifacts with CC, 1 artifact with CZT, 4 early redistributions and 2 discordances about reversibility of thallium defect.– comparison between prone and supine with CZT: quality of prone images was considered as better in 41%, equal in 34% and worse in 25%; there were 2 times more artifacts in supine (14%) than in prone (7%) (p=0.05).ConclusionsWith thallium-201, the GE Discovery NM 530c CZT cardiac camera allows 5 minutes acquisitions with an increased image quality and a reliable diagnosis quality, both in prone and in supine positions

025 Validation of a “low dose thallium 201 protocol” with a cadmium-zinc-telluride (CZT) cardiac camera

BackgroundThallium 201 is the most efficient radiotracer for myocardial perfusion imaging but leads to relative high radiation exposure for patients.ObjectivesWe used a new cardiac CZT camera to decrease the effective dose with thallium-201 in myocardial perfusion imaging.MethodsWe prospectively studied 137 consecutive patients referred for stress myocardial perfusion imaging and who previously had in the last 5 years a myocardial SPECT with thallium-201. We injected at stress a low dose of thallium 201 (1 to 1.2MBq/kg, i.e. 74MBq for 70kgs), performed stress myocardial imaging in 5 to 7mn with a CZT camera GE Discovery NM 530c and redistribution imaging when initial images were abnormal, with reinjection (37MBq) when previous myocardial infarction or severe defect or without reinjection in other cases. We compared the CZT scan with the scan previously performed in the last 5 years with conventional dual head tomographic Anger camera (CC) with a regular dose of thallium-201.ResultsPatients had known coronary artery diseases in 85% of cases, myocardial scar in 38% and ischemia in 20%.The average stress dose was 88 MBq versus 125MBq previously (−30%)The average time for camera acquisition was 6mn versus 13mn (−54%)The cardiac counts statistic was higher with CZT (>1Mcts)By comparison with CC, the quality of CZT images was better (better delineation of left ventricular cavity, visualization of papillary muscles, easier thickening analysis) in 70% of cases, equal in 24% and worse in 6% (6 artefacts, 2 digestive contaminations)Comparison of artefacts showed 30 unmodified, 29 less and 6 additionnal artefacts.By comparison with the previous SPECT, we missed no pathological image; furthermore, we detected 5 true pathological images which were missed with the CC.Calculated effective dose was less than 12mSv when no reinjection and less than 18 mSv when reinjection.ConclusionsWith reduced activities of thallium 201 (−30%) and effective doses between 12 and 18mSv, CZT camera gives reliable high quality imagin