Whole breast and regional nodal irradiation in prone versus supine position in left sided breast cancer

Background: Prone whole breast irradiation (WBI) leads to reduced heart and lung doses in breast cancer patients receiving adjuvant radiotherapy. In this feasibility trial, we investigated the prone position for whole breast + lymph node irradiation (WB + LNI). Methods: A new support device was developed for optimal target coverage, on which patients are positioned in a position resembling a phase from the crawl swimming technique (prone crawl position). Five left sided breast cancer patients were included and simulated in supine and prone position. For each patient, a treatment plan was made in prone and supine position for WB + LNI to the whole axilla and the unoperated part of the axilla. Patients served as their own controls for comparing dosimetry of target volumes and organs at risk (OAR) in prone versus in supine position. Results: Target volume coverage differed only slightly between prone and supine position. Doses were significantly reduced (P < 0.05) in prone position for ipsilateral lung (Dmean, D2, V5, V10, V20, V30), contralateral lung (Dmean, D2), contralateral breast (Dmean, D2 and for total axillary WB + LNI also V5), thyroid (Dmean, D2, V5, V10, V20, V30), oesophagus (Dmean and for partial axillary WB + LNI also D2 and V5), skin (D2 and for partial axillary WB + LNI V105 and V107). There were no significant differences for heart and humeral head doses. Conclusions: Prone crawl position in WB + LNI allows for good breast and nodal target coverage with better sparing of ipsilateral lung, thyroid, contralateral breast, contralateral lung and oesophagus when compared to supine position. There is no difference in heart and humeral head doses

Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate: results from the APPRAISE study

Objectives: To study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX). Methods: In this open-label, multicentre, single-arm study, patients with RA (MTX inadequate responders) received intravenous abatacept (∼10 mg/kg) plus MTX for 24 weeks. A composite PDUS synovitis score, developed by the Outcome Measures in Rheumatology–European League Against Rheumatism (OMERACT–EULAR)-Ultrasound Task Force, was used to evaluate individual joints. The maximal score of each joint was added into a Global OMERACT–EULAR Synovitis Score (GLOESS) for bilateral metacarpophalangeal joints (MCPs) 2–5 (primary objective). The value of GLOESS containing other joint sets was explored, along with clinical efficacy. Results: Eighty-nine patients completed the 24-week treatment period. The earliest PDUS sign of improvement in synovitis was at week 1 (mean change in GLOESS (MCPs 2–5): −0.7 (95% CIs −1.2 to −0.1)), with continuous improvement to week 24. Early improvement was observed in the component scores (power Doppler signal at week 1, synovial hyperplasia at week 2, joint effusion at week 4). Comparable changes were observed for 22 paired joints and minimal joint subsets. Mean Disease Activity Score 28 (C reactive protein) was significantly reduced from weeks 1 to 24, reaching clinical meaningful improvement (change ≥1.2) at week 8. Conclusions: In this first international prospective study, the composite PDUS score is responsive to abatacept. GLOESS demonstrated the rapid onset of action of abatacept, regardless of the number of joints examined. Ultrasound is an objective tool to monitor patients with RA under treatment. Trial registration number: NCT00767325

Reconstruction of ancient wall paintings: digital painting and three-dimensional restoration of the House of Neptune and Amphitrite in Herculaneum

International audienceOne of the aims of the ANR VESUVIA programme (Vivre Ensemble : Société et Urbanisme d’une Ville de l’Italie Antique) is to reconstruct the various phases of the architecture and the ornatus of houses in Herculaneum. The project also aims to disseminate some of its methodology and results by creating a three-dimensional reconstruction of the House of Neptune and Amphitrite at Herculaneum (V, 6-7). To this end, visuals of the decorative schemes of several rooms of the house were created using computer graphics and subsequently incorporated into the 3D model of the house.The digital restoration of the painted walls used a particularly innovative methodology based on the research carried out by the Retro-Color3D programme supported by Archeovision. The objective of the Retro-Color 3D research programme was to develop a methodology that makes it possible to restore the original colours of archeological objects such as painted sculptures or wall paintings by incorporating the effects of texture and irregularities intrinsic to the craft. The triclinium (room 7) of the House of Neptune and Amphitrite presents a case study of this method.The successful digital reconstruction of the paintings was dependent on the ability to define the colours and their relationship to each other as accurately as possible (using colometric measurements) and to find a way of reproducing them. The overall results of this research are presented here.L’un des objectifs du programme ANR VESUVIA (Vivre Ensemble : Société et Urbanisme d’une Ville de l’Italie Antique) est de reconstituer les différentes phases de l’architecture et de l’ornatus des maisons d’Herculanum. Parmi ses achèvements, le projet prévoit de diffuser une partie de ses méthodes et de ses résultats à travers la réalisation d’un modèle 3D de restitution de la Maison de Neptune et Amphitrite à Herculanum (V, 6-7). Dans cet objectif, sont réalisées des infographies de restitution des décors de plusieurs pièces de la maison, lesquelles sont ensuite insérées dans un modèle 3D de la maison.La finalisation des infographies des parois peintes est réalisée selon une technologie de peinture numérique particulièrement novatrice.Grâce à un croisement avec le programme de recherche Retro-Color3D porté par Archeovision, la restitution “totale” des peintures murales a pu bénéficier du travail de recherche effectuée dans ce cadre. L’objectif de Retro-Color 3D était de trouver une méthodologie permettant de rendre à des objets archéologiques (sculpture peinte ou peinture murale) leurs couleurs d’origine en y intégrant les effets de matières et d’irrégularité qui procèdent nécessairement d’un travail artisanal. Le triclinium 7 de la maison de Neptune et Amphitrite en a été l’un des cas d’étude.La restauration numérique des peintures nécessitait de définir les couleurs et leur rapport entre elles le plus justement possible (par mesures colorimétriques) et de trouver comment les reproduire. C’est l’ensemble des résultats produits par ces recherches qui est présenté ici

The colours of the pilasters, clipei and masks of the Chiragan villa. a work in progress

peer reviewedThe aim of the presentation is to discuss the ongoing study of the polychromy on marble sculptures from the villa of Chiragan (Martres-Tolosane, France), exposed at the Saint-Raymond Museum in Toulouse. This exceptional collection, dating from the long period of occupation of the villa (1st - 4th century), is composed by sixty portraits, mainly in oriental marble, as well as by a group of mythological sculptures and architectural decorations in local marble (Saint-Béat), including ornamental elements and masks. Pilasters, clipei and masks – some bacchic, others from theatrical repertoire – will be, here, examined. Following an analytical protocol, coupling visual observation through white light, UVL and IR, optical videomicroscopy and MA-XRF analysis, we confirm the presence of the pictorial finishing and the compositional nature of the preserved colours. In order to better understand and interpret the results of the physico-chemical analyses, and to sketch some elements of restitution, the analysed objects are systematically compared to the same objects represented in other coloured supports (wall paintings, mosaics or even the real materials in which the represented elements were made). The results of this work in progress may provide a better understanding of the initial appearance of certain works and, from a museographic point of view, a renewed reflection on the presentation of these works in the Musée Saint-Raymond in Toulouse and their visual impact