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Biomedical subjects

J Stinès

Publications and source records attributed to J Stinès.

9 recordsLinked to original sources

[Matching of mammary microcalcifications on images from different views].

PURPOSE: In order to increase sensitivity and specificity in the diagnosis of breast cancer, more than one - generally two or three - mammograms of the same breast are obtained. In order to be able to carry out 3D reconstruction of microcalcification clusters on one hand, and efficiently fuse the information they carry on the other hand, one needs to match corresponding regions of microcalcifications from the different views. Unfortunately, this may be difficult at times. To help the situation, we have developed in this paper, a technique to automatically match microcalcifications found on pairs of mammograms from the same breast. MATERIALS AND METHODS: We used the computed morphological characteristics of individual microcalcifications to build a likeness function to match the microcalcifications. The geometrical constraint suitable for the system used was then applied to reduce the possibilities. From the remaining possibilities, the one with the highest likeness was selected as pair of corresponding microcalcifications. RESULTS: This technique was tested on a number of real cases and yielded 77.14% of good matches. CONCLUSION: This technique provides good results and could therefore be used either directly or for 3D-reconstruction of clustered microcalcifications.

Breast Diseases↗

[Prostate cancer].

Radiation therapy of prostate carcinoma with a curative intent implies to treat the whole prostate at high dose (at least 66 Gy). According to clinical stage, PSA level, Gleason's score, the clinical target volume may include seminal vesicles and less often pelvic lymph nodes. Microscopic extracapsular extension is found in 15 to 60% of T1-T2 operated on, specially in apex tumors. On contrary, cancers developing from the transitional zone may stay limited to the prostate even with a big volume and with a high PSA level. Zonal anatomy of the prostate identifies internal prostate, including the transitional zone (5% of the prostate in young people). External prostate includes central and peripheral zones. The inferior limit of the prostate is not lower than the inferior border of the pubic symphysis. Clinical and radiological examination: ultrasonography, nuclear magnetic resonance (NMR), CT-scan identify prognostic factors as tumor volume, capsule effraction, seminal vesicles invasion and lymph node extension. The identification of the clinical target volume is now done mainly by CT-Scan which identifies prostate and seminal vesicles. NMR could be helpful to identify more precisely prostate apex. The definition of margins around the clinical target volume has to take in account daily reproducibility and organ motion and of course the maximum tolerable dose for organs at risk.

Humans↗

[CT and MR imaging of a solitary fibrous tumor of the thigh].

Solitary fibrous tumor is a rare mesenchymal tumor usually involving the pleura. Extrapleural lesions may also occur. We report the CT and MRI appearance of a solitary fibrous tumor of the thigh. The imaging features as well as the histological and immunohistochemical characteristics are presented, especially its reactivity to the CD34 antigen. The tumor is most often benign, particularly in extra-pleural location, with good prognosis after total resection. Imaging is mainly useful to locate the tumor and assess its extension prior to surgery.

Humans↗

[Ductal carcinoma in situ of the breast: role of imaging].

The incidence of ductal carcinoma in situ (DCIS) has increased with the widespread use of screening mammography. DCIS is often suspected when clustered microcalcifications are evidenced on routinely performed mammography. High quality mammographies are required and should be completed with magnification views. Mammographic--pathologic correlations are described according to the new classifications as well as unusual forms of presentation on mammography. Early contrast enhancement in DCIS on dynamic MRI is reported and seems to be related with angiogenesis. A wire localization procedure of non-palpable lesions has to be performed and per-operative specimen radiography is mandatory. Stereotaxic large core needle biopsy is a valuable alternative to surgical biopsy but a multidisciplinary team approach is necessary and follow-up is recommended if no excisional biopsy is done. Quality in the management of DCIS depends on the coherence of the "multidisciplinary team".

Biopsy↗

[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↗

[Mesenteric panniculitis. Aspects in x-ray computed tomography and MRI].

We report one case of mesenteric panniculitis. This rare and poorly-known disease is characterized by a non specific inflammatory process involving adipose tissue of the mesentery. The new imaging techniques (CT and MRI) may be helpful for the diagnosis of this disease and allow avoiding laparotomy. However histological proof remains necessary and can be given by guided needle biopsy.

Humans↗

[Current role of x-ray computed tomographic test in the detection of lesions of peritoneal carcinomatosis].

CT scan is presently the method of choice in the pre-operative evaluation of patients with peritoneal carcinomatosis. The aim of this article is to present the results of a personal work concerning the comparison of CT scan and the surgical data in the diagnosis of peritoneal carcinomatosis and to compare them with data of the literature. Despite the existence of unavoidable bias related to the retrospective characteristic of the study, the results confirm the good sensitivity of the scan in the examination of peritoneal carcinomatosis, through it remains insufficient to do without surgical exploration.

Adolescent↗

[Psychological adjustment of short interval follow-up mammography: about 50 cases].

The objective was to investigate women's perceptions and the perceived stress experience when undergoing surveillance mammography for benign lesions (ACR3, BI-RADS). A semi-prospective study was carried out on women with diagnosed "probably benign" breast abnormalities. It was a multicentric study from 1st March to 10th June 2002. The survey was performed at the first follow-up mammography and included questions about perceptions and perceived stress related to the follow-up experience. The response is analysed with chi-square test. Fifty women (35-75 years) answered the questionnaire. All women were satisfied with reception. The mammographies were painful (23 cases). Subsequent time seemed to be too long (seven cases) and they were anxious in 19 cases. Quality of life was spoiled (disturbed) (20 cases). Professional and social perturbations were not frequent (four cases). Speaking to a relative is frequent (39 cases), but patients were not satisfied with it (33 cases). Medical information was estimated (47 cases) but was not satisfactory (36 cases). The median of the stress scale is 4-5. There are two pickaxes, one at 2 (11 cases), the second at 5 (8 cases). "Low-stressed" women could have an avoidance coping. "High-stressed" women could use a helplessness- hopelessness coping strategy. Women reported a good and informative medical support and adequate comprehension of the short follow-up mammography. They were reassured by the medical care, but the evaluation of the stress level shows it to be high, probably due to the uncertainty of diagnosis.

Adaptation, Psychological↗

Biliary lesions during radiofrequency ablation in liver. Study on the pig.

BACKGROUND: Radiofrequency (RF) is a method of in situ destruction of liver tumor. Biliary complications are bile ducts stenosis or biliary abcess. The aim of this work was to study consequences of liver RF on bile ducts. METHODS: A porcine model of biliary lesions was created using radiofrequency ablation liver. Twenty-two pigs were used for the study. The RF RITA 1500 generator (RITA Medical Systems, Mountain View, Calif., USA) was used for all experiments. The needle was positioned under sonographic control in liver parenchyma beside bile ducts. Two lesions were performed in left liver. Four groups of 5 pigs were treated. The pigs were sacrificed 1 or 3 weeks after the procedure. Pringle maneuver was utilized in half of the RF procedures. An ex vivo cholangiogram was obtained by direct injection into the main bile duct. Samples of RF lesions of liver parenchyma near and at a distance from the RF lesions were taken for pathological studies. RESULTS: Radiological lesions were biliary stenosis, with or without upstream bile duct dilatation, or complete interruption of the bile duct, or extravasation of the radiological contrast agent. Histological lesions of bile ducts were observed near RF lesions and at distance of the RF lesions when a Pringle maneuver was used or when the liver was removed after 3 weeks. CONCLUSIONS: RF ablation in contact of the intrahepatic bile duct induced biliary lesions. Therefore, it is required to stay away from the bile duct or to protect it when performing RF ablation.

Animals↗