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A Tardivon

Publications and source records attributed to A Tardivon.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Diagnosis of infraclinical lesions of the breast with dynamic MRI: results of a prospective and multicenter study].

AIM: To determine the accuracy of dynamic contrast-enhanced subfraction MRI to diagnose nonpalpable breast lesions in a prospective multicenter study. MATERIAL AND METHODS: From June to November 1994, 72 patients had a surgical biopsy for a nonpalpable breast lesion and a preoperative dynamic MR after an informed consent was obtained. MR examinations were performed on 0.5, 1 and 1.5T MR unit. Each center underwent dynamic sequences either in spin or gradient echo in T1 weighted images obtained in less than two minutes before and after injection of Gadolinium-DOTA. The presence/absence of contrast enhancement within two minutes after injection of Gadolinium were considered as positive/negative findings respectively. RESULTS: These 72 women had mammographic (n = 80) or ultrasonographic lesions (n = 2). Mammograms showed mass (n = 23), asymmetrical density (n = 2), architectural distorsion (n = 8), clustered microcalcifications (n = 47) or was normal (n = 2). Dynamic Breast MR imaging showed early contrast enhancement in 44 malignant lesions (sensitivity: 89.8%) and 13 benign lesions (specificity: 60.6%). Five intraductal carcinoma of comedo (n = 1) or non-comedo (n = 4) type did not demonstrate any early contrast enhancement. CONCLUSION: This prospective mulcentric study confirms the high sensitivity of dynamic breast MRI whatever the type of MR unit or sequences.

Adult↗
PubMed1996

Combined systemic chemoimmunotherapy in advanced diffuse malignant mesothelioma. Report of a phase I-II study of weekly cisplatin/interferon alfa-2a.

PURPOSE: To assess the tolerance, toxicity, and antitumoral activity of the weekly combination of cisplatin (CDDP) and interferon alfa-2a (IFNalpha2a) in advanced diffuse malignant mesothelioma (DMM). PATIENTS AND METHODS: Twenty-six patients with DMM (23 pleural and three peritoneal), previously untreated, were enrolled onto this study between August 1991 and December 1992. All patients had measurable disease defined by computed tomographic (CT) scan and diagnostic confirmation by histopathology review panel. IFNalpha2a (3 x 10(6) IU subcutaneously on days 1 to 4) and CDDP (60 mg/m2/wk on day 2) were given weekly. Initially planned as a 5-weeks-on/3-weeks-off treatment cycle, poor patient tolerance observed in the first 12 patients treated (group A) led to schedule adaptation with a shorter treatment sequence and prolongation of the rest period (4 weeks on/4 weeks off) in the following 14 patients (group B). At least two cycles were administered to each patient in the absence of tumor progression. RESULTS: Twenty-six patients were assessable for toxicity and 25 for efficacy (World Health Organization [WHO] criteria). Sixty-eight cycles of IFN/CDDP were given, with a median of three cycles per patient (range, one to five). Toxicity was mainly clinical, with progressive anorexia, asthenia, and prolonged nausea/emesis; these side effects have limited treatment acceptance in many patients. Thrombocytopenia and leukopenia were rarely noted as treatment-limiting toxicities. Objective responses (all partial) were obtained in 10 patients (95% confidence interval [CI], 20% to 60%). The median response duration was 11 months (range, 6 to 18). The median time to progression (TTP) for the whole cohort was 6 months and the median survival time was 12 months (range, 5 to 32). Objective responders had a significantly longer median TTP (21 months) and survival time (25 months) than nonresponders (3 and 8 months, respectively). CONCLUSION: The results of this pilot phase I-II study show encouraging antitumor activity in this traditionally resistant tumor, even if the specific contribution of IFN remains speculative and needs further clinical research. Our ongoing program is exploring the dose-intensity impact of IFN dose within the same combination.

Adult↗
PubMed1996

[Retrospective analysis of 44 adrenal puncture biopsies under x-ray computed tomographic guidance].

Fourty-four CT-guided adrenal biopsies were performed on 43 patients aged 12-74 years old (mean 57 years). The results (benign adrenal tissue, malignant tissue, and nondiagnostic) were compared with outcomes. Diagnostic samples were obtained in 86% of patients. Among the 37 proved cases with diagnostic results (10 benign, 27 malignant), there were 26 true-positives, 1 false-negatives and 10 true-negatives. CT-guided adrenal biopsy had an accuracy of 82%, a sensitivity of 96%, a negative predictive value of 83%. In the 6 patients with nondiagnostic samples 1 mass proved malignant and two masses proved benign. Seven minor complications occurred in 7 patients (6 pneumothoraces and 1 retroperitoneal hemorrhage). CT-guided adrenal biopsy is a simple safe and well tolerated technique. In oncologic patients, obtaining benign adrenal tissue was highly predictive of benignity.

Adolescent↗
PubMed1995

Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission.

BACKGROUND: Prophylactic cranial irradiation in patients with small-cell lung cancer decreases the overall rate of brain metastases without an effect on overall survival. It has been suggested that this treatment may increase neuropsychological syndromes and brain abnormalities indicated by computed tomography scans. However, other retrospective data suggested a beneficial effect on overall survival for patients in complete remission. PURPOSE: Our purpose was to evaluate the effects of prophylactic cranial irradiation on brain metastasis, overall survival, and late-occurring toxic effects in patients with small-cell lung cancer in complete remission. METHODS: We conducted a prospective study of 300 patients who had small-cell lung cancer that was in complete remission. The patients were randomly assigned to receive either prophylactic cranial irradiation delivering 24 Gy in eight fractions during 12 days (treatment group) or no prophylactic cranial irradiation (control group). A neuropsychological examination and a computed tomography scan of the brain were performed at the time of random assignment and repeatedly assessed at 6, 18, 30, and 48 months. Patterns of failure were analyzed according to total event rates and also according to an isolated first site of relapse, using a competing-risk approach. RESULTS: Two hundred ninety-four patients who did not have brain metastases at the time of random assignment were analyzed. The 2-year cumulative rate of brain metastasis as an isolated first site of relapse was 45% in the control group and 19% in the treatment group (P < 10(-6)). The total 2-year rate of brain metastasis was 67% and 40%, respectively (relative risk = 0.35; P < 10(-13)). The 2-year overall survival rate was 21.5% in the control group and 29% in the treatment group (relative risk = 0.83; P = .14). There were no significant differences between the two groups in terms of neuropsychological function or abnormalities indicated by computed tomography brain scans. CONCLUSIONS: Prophylactic cranial irradiation given to patients with small-cell lung cancer in complete remission decreases the risk of brain metastasis threefold without a significant increase in complications. A possible beneficial effect on overall survival should be tested with a higher statistical power. IMPLICATIONS: The results of the trial favor, at present, the indication of prophylactic cranial irradiation for patients who are in complete remission. A longer follow-up and confirmatory trials are needed to fully assess late-occurring toxic effects. The possible effect on overall survival needs to be evaluated with a larger number of patients in complete remission, and a meta-analysis of similar trials is recommended.

Aged↗
PubMed1995

[Morphological and functional study of pulmonary arteries by MRI].

This article presents an exhaustive review of MRI in the assessment of the pulmonary arteries (sequences, normal results, clinical signs of the main diseases). Its current preferential indications are: the study of the main pulmonary artery trunks (primary tumours, proximal embolism, caliber abnormalities, anatomical relations with central tumours), the assessment and post-treatment follow-up of pulmonary arterial malformations. Angio-MRI is currently being developed and, in the near future, should allow the reliable diagnosis of pulmonary embolism and will therefore be indicated alongside spiral computed tomography. MRI also allows functional assessment of the right circulation (measurements of circulatory velocity and flow rates). It should rapidly become an examination of choice in the haemodynamic follow-up of patient with pulmonary hypertension and transplant recipients and as an evaluation tool for new drugs.

Humans↗
PubMed1994

Head and neck rhabdomyosarcomas in children: value of clinical and CT findings in the detection of loco-regional relapses.

Between 1984 and 1990, 16 children who had been treated for a histologically proven head and neck rhabdomyosarcoma developed 19 local recurrences. Fourteen relapses discovered in 11 children (group 1) were based on clinical data acquired 3 to 52 months after completion of treatment. Clinical symptoms (12 patients) or examination (2 patients) led to suspicion of a relapse. The clinical presentation of relapses and that of primary tumour were identical in eight cases. CT scans performed prior to recurrence revealed a stable 'post-therapeutic residue' without mass effect at the original site (12 patients) or was normal (2 patients). Six of these 11 children died at 1 to 15 months and five are alive 12 to 36 months after treatment of recurrence. Five relapses were discovered on CT studies 3 to 15 months after completion of treatment in the remaining five children (group 2). Clinical examination was normal in all cases. CT scans performed 3 months before recurrence showed a stable 'post-therapeutic residue' (4 patients) or was normal (1 patient). All of these five children died 3 to 23 months after the relapse.

Adolescent↗
PubMed1994

MR imaging in the follow-up of malignant and aggressive soft-tissue tumors: results of 511 examinations.

PURPOSE: To present magnetic resonance (MR) imaging findings from 511 follow-up examinations of aggressive soft-tissue tumors. MATERIALS AND METHODS: One hundred eighty-two patients with aggressive soft-tissue tumours underwent postoperative T1- and T2-weighted imaging; 41 also underwent 51 gadolinium-enhanced T1-weighted examinations, and five underwent dynamic gadolinium-enhanced subtraction imaging. RESULTS: Twenty-four of 25 patients (101 of 102 examinations) without high signal intensity (HSI) at T2-weighted imaging had no recurrence. Among 79 patients (321 examinations) who demonstrated HSI without a mass, only two tumors recurred within 1 year. An HSI mass was found in 88 studies of 78 patients and represented recurrence (n = 60), hygroma (n = 24), or a radiation-induced pseudomass (n = 4). Hygromas did not enhance, while recurrences enhanced at 1-3 minutes and postirradiation change enhanced at 4-7 minutes. CONCLUSION: T2-weighted imaging can be used to identify possible recurrence of aggressive soft-tissue tumors, while gadolinium-enhanced imaging can be used to differentiate recurrences from hygromas and inflammatory change.

Adolescent↗
PubMed1994

Apocrine carcinoma: clinical and mammographic features.

PURPOSE: To describe the mammographic features of apocrine carcinoma and assess the patterns of calcifications associated with these lesions. MATERIALS AND METHODS: Clinical and mammographic features from 17 patients with apocrine carcinoma were retrospectively reviewed. Special attention was paid to the presence of mixed form, diffusely scattered microcalcifications on mammograms. RESULTS: Patients were referred for clinical (n = 10), mammographic (n = 2), or both clinical and mammographic (n = 5) abnormalities. Findings at clinical examination included a palpable breast mass (n = 12), multiple breast masses (n = 1), and bloody nipple discharge (n = 2); two patients had normal findings. Fourteen patients had opacities at mammography. These opacities were associated with microcalcifications in 10 cases. Three patients had microcalcifications without opacities; one of those three patients exhibited a mixed form of diffusely scattered calcifications. CONCLUSION: Clinical and mammographic features of apocrine carcinoma do not differ from those of invasive ductal carcinoma.

Adult↗
PubMed1994

Nonpalpable breast tumors: diagnosis with contrast-enhanced subtraction dynamic MR imaging.

PURPOSE: To determine the accuracy of contrast material-enhanced subtraction dynamic magnetic resonance (MR) imaging in the diagnosis of nonpalpable breast tumors. MATERIALS AND METHODS: One hundred forty-three patients underwent surgical biopsy of a nonpalpable breast lesion. Their mammograms showed microcalcifications (n = 80), opacity (n = 52), architectural distortion (n = 10), or asymmetric density (n = 1). All patients underwent a preoperative gadolinium tetraazacyclododecanetetraacetic acid-enhanced subtraction dynamic study. Any early contrast enhancement in the breast parenchyma was considered pathologic. RESULTS: At histologic analysis, 27 intraductal carcinomas, 37 invasive carcinomas, and 79 benign lesions were found. Dynamic MR studies showed early contrast enhancement in 61 of 64 breast cancers (sensitivity, 95%) and in 37 of 79 benign lesions (specificity, 53%). Two invasive lobular carcinomas and one tubular carcinoma showed no early contrast enhancement. CONCLUSION: Subtraction dynamic MR imaging may be helpful to rule out malignancy in nonpalpable breast tumors.

Adult↗
PubMed1993

High-precision MR velocity mapping by 3D-Fourier phase encoding with a small number of encoding steps.

The final result of Fourier velocity mapping is a set of images, each representing the spatial distribution of spins at a given velocity. To acquire data in a short time, the number of encoding gradient steps must be as small as possible, but this can mean sacrificing velocity resolution. We used interpolation methods to obtain high velocity resolution with a small number of encoding steps involving linear interpolation from 16 encoding steps or more and zero-filling interpolation from two to eight encoding steps. Velocity measured by interpolated Fourier-flow encoding agreed well with values obtained using a calibrated phantom. A simulation of noise on the images of the phantom showed that, for a given acquisition time, increasing number of encoding steps in the Fourier flow encoding gave better precision for velocity measurement than did averaging identical signals in phase-mapping methods.

Algorithms↗
PubMedDate not supplied

In vivo comparison of two through-plane MR velocity mapping methods: fast Fourier encoding and phase mapping.

Magnetic resonance imaging maps of velocity were acquired with a 1.5-T system in 10 subjects in a plane perpendicular to the main pulmonary artery. Velocity images were successively acquired with a method developed from Fourier-encoding velocity imaging (FEVI) principles with eight gradient steps and one excitation, and with two-point phase-subtraction mapping. Reconstruction in FEVI was implemented by zero-filling interpolation around the eight gradient steps and then around the four central steps. The methods were compared by using estimates of noise in velocity measurements based on the difference between the experimental map and a smooth fitted map. For the same acquisition time, FEVI with four encoding steps was more precise in velocity measurements than phase mapping. Precision was further increased by the use of eight encoding steps, but acquisition time was doubled.

Adult↗
PubMedDate not supplied

[Alternating chemotherapy and hyperfractionated accelerated radiotherapy in non-metastatic inflammatory breast cancer].

PURPOSE: Based on encouraging results reported in alternating radiotherapy and chemotherapy in inflammatory breast carcinoma, we have tried in this study to optimize locoregional treatment with a hyperfractionated accelerated radiotherapy schedule alternating with chemotherapy. PATIENTS AND METHODS: From May 1991 to May 1995, 54 patients, previously untreated, with non-metastatic inflammatory breast cancer were entered in an alternating protocol consisting of eight courses of combined chemotherapy and two series of loco-regional hyperfractionated accelerated radiotherapy with a total dose of 66 Gy. Hyperfractionated accelerated radiotherapy was started after three courses of neoadjuvant chemotherapy (Adriamycin, Vincristine, Cyclophosphamide, Methotrexate, 5-fluoro-uracile) administered every 21 days +/- G.CSF. The first series delivered 45 Gy/three weeks to the breast, the axillary, subclavicular and internal mammary nodes, with two daily sessions of 1.5 Gy separated by an interval of eight hours; the second series consisted of a boost (21 Gy/14 fractions/10 d) alternating with another regimen of anthracycline-based-chemotherapy (a total of five cycles every three weeks). Hormonal treatment was given to all patients. RESULTS: Of the 53 patients evaluated at the end of the treatment, 44 (83%) had a complete clinical response, seven (13%) had a partial response (> 50%) and two (4%) had tumoral progression. Of the 51 patients who were locally controlled, 18 (35%) presented a locoregional recurrence (LRR); eight (15%) had to undergo a mastectomy. All the patients but two with LRR developed metastases or died of local progressive disease and 26 (50%) developed metastases. With a median follow-up of 39 months (range: 4-74 months), survival rates at three and five years were respectively, 66 and 45% for overall survival and 45 and 36% for disease-free survival. CONCLUSION: Alternating a combination of chemotherapy and hyperfractionated accelerated radiotherapy is a well-tolerated regimen which provides acceptable local control. The systemic dissemination remains the major problem of inflammatory breast carcinoma and further clinical trials using alternative drug regimens are warranted.

Adenocarcinoma↗
PubMedDate not supplied

Value of high-frequency US for preoperative assessment of skin tumors.

The purpose of this study was to evaluate the accuracy of high-frequency ultrasound (US) in the preoperative assessment of skin tumors. A US scanner with a 20-MHz probe was used to visualize and evaluate 70 skin lesions (38 clinically suspected melanomas and 32 suspected basilar cell carcinomas [BCCs]) before surgical resection. A US morphologic study and a Doppler analysis of vascularity were performed for each tumor. Of the 70 tumors, 62 were clearly visualized, including 19 melanomas, 12 nonmalignant nevi, and 31 BCCs. Most lesions were hypoechoic. In 13 of 19 proved melanomas, the difference between the histologic and US measurements was equal to or less than 0.2 mm. Vessels were visualized in melanomas with thicknesses greater than 3 mm. All BCCs were visualized, and in 29% of cases of BCC, tumor size at US was greater than that at clinical examination. High-frequency, high-resolution US is a simple, reliable, noninvasive method for accurate preoperative assessment of skin tumor dimensions. This technique allows surgical planning to be adapted and reexcision to be avoided. However, its role is limited in the differential diagnosis of malignant and benign skin lesions.

Basal Cell Carcinoma↗
PubMedDate not supplied

Unusual radiologic findings in the thorax after radiation therapy.

Radiation therapy is used to treat many intrathoracic and chest wall malignancies. A variety of changes may occur after radiation therapy to the thorax. Radiation therapy produces dramatic effects in the lung. Pulmonary necrosis is an uncommon, severe, late complication of adjuvant postoperative radiation therapy. Bronchiolitis obliterans with organizing pneumonia is a distinct clinicopathologic entity characterized by patchy, migratory, peripheral air-space infiltrates. Radiation therapy can also cause spontaneous pneumothorax, mesothelioma, and lung cancer. In the mediastinum, radiation therapy may cause thymic cysts, calcified lymph nodes, and esophageal injuries. Cardiovascular complications of radiation therapy are often delayed and insidious. Premature coronary artery stenosis occurs after radiation therapy to the mediastinum. Radiation therapy may also give rise to calcifications of the ascending aorta, pericardial disease, valvular injuries, and conduction abnormalities. Women who undergo thoracic irradiation before the age of 30 years have a high risk of developing a second breast cancer. Radiation-induced sarcomas are an infrequent but well-recognized complication of radiation therapy. Other chest wall injuries due to radiation therapy are osteochondroma and rib or clavicle fractures. Knowledge of the imaging features of injuries caused by radiation therapy can prevent misinterpretation as recurrent tumor and may facilitate further treatment.

Bone and Bones↗