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Biomedical subjects

M Laval-Jeantet

Publications and source records attributed to M Laval-Jeantet.

At least 19 recordsLinked to original sources

[Digital radiography of the thorax].

Digital radiography of the thorax can, now be substituted to conventional chest radiography. Computed radiography with phosphor plates and the new selenium detector are emphasized. The major image processing are explained. Successively the main other methods of digital radiography are described: scanning equalization radiography, laser-digitized radiography and multiwire proportional chambers. Then the advantages and the drawbacks of chest computed radiography are extensively reviewed.

Humans

[Cervico-mediastinal recurrences of differentiated thyroid cancers: value of MRI].

AIM: The aim of this study was to evaluate the ability of MRI to detect recurrent differentiated thyroid carcinomas developed in the neck or the upper mediastinum. RESULTS: MRI was performed in 25 patients, and was compared in 5 cases with surgery. In 20 cases it was compared with I-131 scintigraphy (100 mCi in 14 cases and 5 mCi in 6 cases). The sensibility, specificity and overall accuracy of MRI was respectively: 100%, 66.6%, 82.6%. COMMENTARY: MRI is a good technique to detect recurrent thyroid carcinomas. It is specially interesting to investigate patients with a biological suspicion of recurrence and a negative scintigraphy. Mediastinal localisations that cannot be detected by US can be detected by MRI.

Adult

Evolution of bone densitometry in patients with myeloma treated with conventional or intensive therapy.

BACKGROUND: Demineralization is a common hallmark of multiple myeloma (MM) that can be evaluated by dual-energy X-ray absorptiometry (DEXA). The evolution of lumbar and whole body bone density were investigated by DEXA in patients with MM treated by conventional or intensive therapy supported by autologous blood stem cell transplantation. METHODS: Sixty six patients younger than 66 years with MM were randomly assigned to either conventional (30 patients, Group A) or intensive therapy supported by autologous blood stem cell transplantation (36 patients, Group B). For all patients, lumbar bone mineral density (BMD) was measured by DEXA at diagnosis and 13.2 +/- 4.2 months after the initiation of treatment. Whole body examinations were performed in 45 patients; in addition to whole body BMD, independent BMD values were recorded for various skeletal sites. RESULTS: At diagnosis, mean lumbar Z score (lumbar mean BMD value) was low (-1.24 +/- 1.45) without any significant difference between the 2 groups. Under treatment, lumbar BMD increased 0.7% in Group A and 4.6% in Group B (P = 0.02). This difference was mainly related to nonresponders in group A who featured a lumbar BMD change of -3.9%, whereas patients in remission in both groups displayed a 4.1% increase (P < 0.001). There was a correlation between the variation of lumbar BMD and the decrease of the serum or urinary monoclonal component (r = 0.34, P = 0.006). After intensive therapy, increase of lumbar BMD was higher in men than in women (7.2% vs. 1%, P = 0.005) perhaps because of variations in hormonal status in women. Unexpectedly, whole body BMD decreased in responders (-3%) because of a decrease in appendicular BMD outweighing the increase in axial BMD. This suggests a redistribution from cortical to cancellous bone in patients with MM responsive to chemotherapy. CONCLUSION: Bone densitometry is a marker of treatment response that may be particularly useful in nonsecretory and light chain MM. Moreover, it provides new information on bone remodeling in patients treated for MM, which may have therapeutic consequences.

Absorptiometry, Photon

Dual-energy X-ray absorptiometry of the calcaneus: comparison with vertebral dual-energy X-ray absorptiometry and quantitative computed tomography.

The purpose of this study was to determine the efficacy of using bone mineral measurements of the calcaneus to evaluate osteoporosis. Dual energy X-ray absorptiometry (DXA) of the calcaneus was compared with posteroanterior lumbar absorptiometry (DXA) and vertebral quantitative computed tomography (QCT) measurements in 171 white women (78 normal and 93 osteoporotic). DXA measurement of os calcis mineralization decreased significantly in osteoporosis, but to a lesser extent than in vertebral sites. In normal subjects, good correlations were observed between calcaneal and lumbar DXA (0.69) and QCT (0.56). In subjects with vertebral fractures, there was also good correlation between calcaneal DXA and QCT (0.59-0.69). This suggests that trabecular bone in calcaneus and vertebrae have related involution in cases of vertebral osteoporosis. However, the extent of bone loss is less marked in the calcaneus than in the vertebrae and is not sufficient to be accurately measured over time. We conclude, therefore, that although the global densitometric measurement at this site is not sufficiently sensitive for general use, it can be useful as a epidemiological research tool.

Absorptiometry, Photon

Magnetic resonance imaging in patients with penile carcinoma.

The aim of the study was to determine the role of pre-operative magnetic resonance imaging (MRI), with and without contrast enhancement, in patients with penile carcinoma. Nine patients with a penile cancer were studied. The staging of the tumours was performed by clinical examination, MRI and surgery, according to the TNM classification. Six patients had primary tumours, of clinical stage T1 (n = 1) and T2 (n = 5). Three other patients had been previously treated and presented with a local recurrence of clinical stage T2. Surface-coil MRI was performed at 0.5 T with T1 weighted sequences before and after gadolinium-DOTA, and T2 weighted sequences. MRI results were compared with the clinical and surgical findings. T1 weighted sequences did not clearly demonstrate the margins of the tumours. T2 weighted sequences were the more useful in five patients, whereas contrast enhanced T1 weighted sequences allowed better delineation of the lesions in only three patients. Therefore, an imaging protocol should include spin echo T2 weighted sequences. Clinical examination correctly staged six of nine tumours; MRI, seven of nine tumours and the combination of both examinations, eight of nine tumours. MRI provided good evaluation of tumoral invasion into the penile shaft.

Adult

MR of cerebral aspergillosis in patients who have had bone marrow transplantation.

PURPOSE: To assess the CT and MR appearance of cerebral aspergillosis in patients who have undergone bone marrow transplantation. METHODS: The imaging and clinical data of five patients with cerebral aspergillosis were reviewed retrospectively and compared with autopsy findings. RESULTS: Lesions are often located in the basal ganglia and demonstrate an intermediate signal intensity within surrounding high-signal areas on long-repetition-time MR scans. The lesions were multiple in four of the five patients and more numerous on MR images than on CT scans. The lesions (which demonstrate no parenchymal enhancement) are consistent with acute infarcts as confirmed at autopsy. In the large lesions, there is early intravascular and meningeal enhancement, as expected in acute infarcts involving an appreciable portion of the territory of a cerebral artery. CONCLUSION: The diagnosis of early cerebral infarction in a patient considered at risk for invasive aspergillosis, even without overt pulmonary disease, is an indication to institute aggressive antifungal therapy.

Adult

Ultrasound attenuation imaging in the os calcis: an improved method.

A complete assessment of the broadband ultrasonic attenuation (BUA) distribution within the os calcis was made using an ultrasonic mechanical scanning device with focused transducers. Measurements were performed on 12 os calces removed from fresh female cadavers. We present the first images of BUA of the os calcis. Reasonably high quality images were obtained compared to computed tomography. The resolution provided by the focused transducers is approximately 4 or 5 mm in the focal zone. Compared to dual energy X-ray absorptiometry (DEXA) or quantitative computed tomography, ultrasound imaging of the os calcis offers the possibility of controlling the placement, size and shape of the region of interest and to use multiple measurement sites. DEXA was used systematically to measure the bone mineral density (BMD) of the os calces. A highly significant correlation between BMD and BUA was found (r = 0.97 p < 0.001).

Absorptiometry, Photon

[Radiological aspects of invasive aspergillosis].

Invasive aspergillosis is a life-threatening illness, whose diagnosis is difficult: clinical signs are indeed not specific, and biological and mycological exams are not always conclusive. Radiological exams are essential for the diagnosis of this disease allowing to start an early intensive appropriate therapy. According to the literature and to their own experience the authors report the main radiological patterns with emphasis on the pulmonary and cerebral affections.

Aspergillosis

[Radiography of the thorax with phospholuminescent screens].

Image digitalization can be performed in several ways: equalization of the x-ray beam (Scanning Equalization Radiography and Advanced Multiple-Beam Equalization Radiography), digital fluorography, use of linear computed tomography detectors, digitalization of radiographic films and memory screens. Phospholuminescent screens use an x-ray receptor which is able to store the x-ray energy. This latent energy is then extracted and can be processed to obtain images with matrices ranging between 1,760 x 2,140 and 1,770 x 2,370. Several types of image processing systems can be used depending on the pathology investigated. The blurred mask substraction method is the most widely used. The first clinical results demonstrate a reduction in patient irradiation and performances equal to or better than those of standard x-rays.

Humans

CT image analysis of the vertebral trabecular network in vivo.

A method of computed tomography (CT) image analysis of lumbar vertebrae has been developed, providing a visualization of the trabecular network as it is represented in a 1.5 mm-thick CT image. We measured the length of the network and the number of discontinuities found in the image. The ratio of these measurements was called the "trabecular fragmentation index" (TFI). CT images from 71 women between the ages of 50 and 59, and 94 women between the ages of 60 and 69 were divided into three groups according to quantitative computed tomography (QCT) vertebral density and to the presence or absence of crushing and fractures. The measure of the network length versus the vertebral area was significantly higher in normal subjects than in osteoporotics. A TFI threshold at 0.195 could separate the normal subjects, regardless of the decade, from osteoporotic ones. In females between 50 and 69 years of age, TFI was 0.166 (SD = 0.031) for the normal group and 0.248 (SD = 0.082) for osteoporotics. The osteopenic group without fractures but low bone mineral density (BMD) showed an intermediate TFI of 0.195 (SD = 0.05), placing this population on both sides of the threshold. Correlation between TFI and BMD was only -0.60. TFI could provide new information in vivo about the state of trabecular structure, particularly in the osteopenic group.

Aged

MR imaging of breast hemangioma in female infants.

Breast hemangioma in female infants is a rare benign lesion, prone to spontaneous regression. But when the lesion regresses there is a risk of breast atrophy if the breast bud is included in or very close to the hemangioma. A trial of corticosteroid therapy could be proposed to prevent this risk, but one must be sure that the breast bud is included in or very close to the hemangioma before treatment. We studied 4 children with breast hemangioma to evaluate the ability of MR Imaging in the diagnosis of breast bud inclusion. 0.5 Tesla axial Spin Echo T2-weighted images (TR = 2000 ms; TE = 120 ms) clearly depicted interface between high signal appearance of hemangioma and hypo-intensity of the breast bud: in our four patients we were able to determine whether or not the hemangioma involved the breast bud. Our preliminary study seems to demonstrate that MR imaging is a valuable imaging technique to determine which patients could be eligible for a trial of corticosteroid therapy.

Breast Neoplasms

Bone densitometry in patients with multiple myeloma.

PURPOSE, PATIENTS, AND METHODS: We performed dual-energy x-ray absorptiometry in 10 selected patients with aggressive multiple myeloma in whom substantial tumor mass reduction was achieved after high-dose chemoradiotherapy followed by autologous blood stem cell transplantation. RESULTS: In most cases, bone mineral density (BMD) of the spine was initially low (Mean Z score: -2.69, SEM 0.76) and dramatically increased after treatment (mean increase 16.4%; 7.7% with 95% confidence interval 2.2 to 12.2, excluding one patient whose spine BMD increased by 94.8%). In contrast, skeletal roentgenograms, computed tomographic scans, and magnetic resonance imaging did not reveal any significant improvement of patients' bone lesions. CONCLUSIONS: In patients with multiple myeloma, bone densitometry could be a useful way to assess the efficacy of treatment on bone status.

Absorptiometry, Photon