Foucauld Chamming's

Diffusion-weighted imaging for evaluation of uterine arterial embolization of fibroids.

To determine whether diffusion‐weighted imaging (DWI) characteristics could predict the effectiveness of uterine arterial embolization in treatment of fibroids.

In Vivo Quantification of the Nonlinear Shear Modulus in Breast Lesions: Feasibility Study

Breast cancer detection in the early stages is of great importance since the prognosis, and the treatment depends more on this. Multiple techniques relying on the mechanical properties of soft tissues have been developed to help in early detection. In this study, we implemented a technique that measures the nonlinear shear modulus (NLSM) (μNL) in vivo and showed its utility to detect breast lesions from healthy tissue. The technique relies on the acoustoelasticity theory in quasi-incompressible media. In order to recover μNL, static elastography and supersonic shear imaging are combined to subsequently register strain maps and shear modulus maps while the medium is compressed. Then, μNL can be recovered from the relationship between the stress, deduced from strain maps, and the shear modulus. For this study, a series of five nonlinear phantoms were built using biological tissue (pork liver) inclusions immersed in an agar-gelatin gel. Furthermore, 11 in vivo acquisitions were performed to characterize the NLSM of breast tissue. The phantom results showed a very good differentiation of the liver inclusions when measuring μNL with a mean value of -114.1 kPa compared to -34.7 kPa for the gelatin. Meanwhile, values for the shear modulus for the liver and the gelatin were very similar, 3.7 and 3.4 kPa, respectively. In vivo NLSM mean value for the healthy breast tissue was of -95 kPa, while mean values of the benign and the malignant lesions were -619 and -806 kPa with a strong variability, respectively. This study shows the potential of the acoustoelasticity theory in quasi-incompressible medium to bring a new parameter for breast cancer diagnosis.

Assessment of different pre and intra-operative strategies to predict the actual ESMO risk group and to establish the appropriate indication of lymphadenectomy in endometrial cancer

PURPOSE OF INVESTIGATION The objective of this study was to evaluate the best pre- and intra-operative strategy to determine the European Society for Medical Oncology (ESMO) risk group. MATERIALS AND METHODS Retrospective study on patients supported for endometrial cancer between 2006 and 2011. Twelve algorithms, integrating endometrial biopsy for histological type and tumour grade, and ultrasound and/or magnetic resonance imaging (MRI)±intra-operative examination for determination of myometrial invasion, were built. The diagnostic values of each algorithm to predict high- and low-risk group were calculated. RESULTS During the study period, 159 patients were operated for endometrial cancer. On these 159 patients, 103 met the inclusion criteria. For the prediction of high-risk group, the best algorithm was endometrial biopsy and ultrasound, combined with MRI in case of myometrial invasion <50%±intra-operative examination in case of myometrial invasion <50% on MRI. For the prediction of low-risk group, the 2 best algorithms were endometrial biopsy and ultrasound or MRI, combined with MRI or ultrasound in case of myometrial invasion <50% and intra-operative examination in case of discrepancy between both exams. There was no internal or external validation. CONCLUSION Our study suggests that the best strategy to predict actual ESMO risk group is endometrial biopsy and transvaginal ultrasound±MRI and intra-operative examination in case of myometrial invasion <50% on ultrasound.

Cáncer de endometrio: diagnóstico y evaluación preterapéutica

El cancer de endometrio es una patologia muy frecuente y de buen pronostico en un estadio precoz. Para el ginecologo o el medico general es fundamental establecer el diagnostico de forma precoz. Esto supone conocer los factores de riesgo y los signos de alarma, y efectuar la evaluacion complementaria adecuada que permita adoptar una conducta terapeutica rapida y adaptada. El proposito de este articulo es tratar todos los puntos importantes del diagnostico y de la evaluacion preterapeutica con el fin de obtener los elementos necesarios para un tratamiento optimo.