Tomographie par émission de positons au (18 F)-fluorodésoxyglucose dans les cancers du col utérin: évaluation ganglionnaire et valeur pronostique/prédictive des données de la tumeur primitive [((18)F)-fluorodeoxyglucose PET/CT in cervix cancer: lymph node assessment and prognostic/predictive value of primary tumour analysis].

National audiencePURPOSE: In cervix carcinoma: (a) to evaluate the ability of ((18)F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the lymph node detection; (b) to investigate the prognostic and predictive value of the primary cervical PET parameters. PATIENTS AND METHODS: Ninety patients treated for cervix carcinoma and evaluated initially by MRI and FGD PET were included. The performances of FDG-PET for lymph node detection (relatively to the lymph node dissection) have been described (sensitivity, specificity, positive predictive value and negative predictive value). PET tumour parameters analyzed were: maximum standard uptake value (SUVmax), the volume and the maximum diameter. The prognostic and predictive values of these parameters were investigated. The tumour response was evaluated on surgical specimens. RESULTS: PET detected the cervical tumour with a sensitivity of 97% (mean values: SUVmax=15.8, volume=27 mm(3), maximum diameter=47). For the detection of the lymph nodes, the values of sensibility, specificity, positive predictive value and negative predictive value were: 86, 56, 69 and 78% in the pelvic, and 90, 67, 50 and 95% for the para-aortic area, respectively. The SUVmax was correlated with histologic response (P=0.04). The frequency of partial histological response was significantly higher for tumour SUVmax>10.9 (P=0.017). The maximum PET diameter and pathologic response had an impact on disease-free survival and overall survival in multivariate analysis (P<0.05). CONCLUSION: PET has high sensitivity in detecting pelvic and para-aortic lymph nodes. Some primary cervical tumour PET parameters are useful as prognostic and predictive factors

The Siting of Livestock Facilities and Environmental Regulations

"The significant variation in the stringency of environmental regulations across Ontario municipalities in the late 1990s created the possibility of pollution havens where expanding livestock operations would locate in those municipalities with the lowest regulatory compliance costs. Using actual building permit data rather than aggregate regional production numbers, the study examined the factors affecting spatial changes. Instead of locating to reduce environmental compliance costs as suggested by the pollution haven hypothesis, barns are being built largely where the livestock sector is concentrated suggesting the existence of agglomeration economies. The result suggests that the normalization of standards across the province through the new Nutrient Management Act will not significantly influence the location decisions of expanding or new livestock facilities which are largely determined by economic factors associated with livestock infrastructure support." Copyright 2006 Canadian Agricultural Economics Society.