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A Tardivon

Publications and source records attributed to A Tardivon.

At least 19 recordsLinked to original sources
PubMed2003

[Interventional radiology in nonpalpable lesions of the breast].

The increasing number of nonpalpable breast lesions found at screening mammography has induced the development of percutaneous imaging-guided procedures to reduce the number of surgical biopsies. After a description of the indications (classification of the American College of Radiology), the different types of sampling procedures (fine needle aspiration, core and large-core biopsies) will be described and the material used also. Depending on the type of breast lesions (mass, clustered microcalcifications), ultrasound--guided and stereotactic--guided biopsies will be explained. Clear information to the patients, efficient quality control and multidisciplinary approach are mandatory for the success of these percutaneous diagnostic procedures.

Biopsy, Fine-Needle↗
PubMed2002

[Radiologic-pathologic correlations in breast diseases].

The objective of this article is to explain radiologic patterns of benign and malignant breast lesions (masses, microcalcifications) based on histological correlations. The stromal fibrous reaction associated to infiltrating carcinomas is responsible of focal increased density, and architectural distorsion, ultrasound acoustic shadowing; abnormal neoangiogenesis can be detected by Doppler, CT or MR imaging. Invasive carcinomas without spiculated margins are poorly differentiated tumors. Mammographic patterns of microcalcifications depend on their physiopathological process (necrosis, secretion), and the shape of clusters (round, triangular) typifies their anatomical site of origin (lobular, ductal). Less frequent lesions (invasive lobular, mucinous, and medullary carcinomas, radial scar) will be also explained based on radiopathological correlations. Knowledge of radiopathological correlations in breast diseases helps the radiologists to analyze and characterize breast lesions.

Breast Diseases↗
PubMed2000

MRI of bone marrow disorders.

Four factors can be used in MR of bone marrow: fat-water distribution, artifacts induced by bone trabeculae, diffusion, and uptake of contrast media. Fat-water is imaged using T1-weighted spin-echo, short tau inversion recovery (STIR), and fast STIR, in- and out-of-phase gradient echo, and fat pre-saturation sequences; bone trabeculae by gradient echo with long TE; diffusion by single-shot spin-echo. The injection of contrast media is a more easy and efficient way to improve the specificity. The value and limitations of those sequences are discussed in marrow replacements (metastases, lymphoma, leukemia) and in myeloid hyperplasia or depletion.

Bone Marrow↗
PubMed1999

Gallium scan in the evaluation of post chemotherapy mediastinal residual masses of aggressive non-Hodgkin's lymphoma.

Optimal evaluation of residual masses of non Hodgkin's lymphomas (NHL) after chemotherapy is of major importance, and gallium scan (GS) is routinely used for this purpose, particularly for mediastinal sites. However, sensitivity and specificity of GS in this setting has been diversely appreciated and needs to be more accurately defined especially if radiotherapy is not planned. A retrospective analysis selected all the patients treated in a single institution for aggressive NHL who presented a residual mass in the mediastinum after chemotherapy and who were evaluated by GS. The value of GS for distinguishing true complete responses (CR) from partial responses (PR) was analyzed in patients who were either submitted to resection of their residual mass or followed up without further treatment after GS. A residual mass with mean perpendicular diameters measuring 4.1 cm x 2.8 cm was found in 42 patients and was GS positive in 8 cases and negative in 34 cases. After GS, radiotherapy was delivered to 10 patients, but 12 patients underwent resection of their residual mass and 20 were followed up without further treatment. In the patients who did not receive radiotherapy, 3 false positive and 6 false negative GS results were disclosed. The specificity and the sensitivity of GS were 88% and 25%, and its positive predictive value and negative predictive value 40% and 78%, respectively. GS was not sufficiently reliable to evaluate post chemotherapy residual masses. Surgical resection of residual masses should be considered particularly in young patients. Patients in true CR should be spared pointless radiotherapy and its late side effects, while patients in PR may benefit from further intensified chemotherapy followed by radiotherapy.

Adolescent↗
PubMed1998

Dynamic contrast-enhanced MRI with subtraction of aggressive soft tissue tumors after resection.

OBJECTIVE: To report the application of dynamic contrast-enhanced subtraction MRI for detecting recurrences in aggressive or malignant soft tissue tumors. DESIGN: The imaging studies consisted of static (T1- and T2-weighted spin-echo) acquisitions, followed by dynamic conventional spin-echo short TR/TE images (at 45 s, 1 min 30 s and 5 min) after a bolus of intravenous contrast medium. Contrast images were subtracted from the precontrast scan on the console. PATIENTS: Ninety-eight patients were studied who had had aggressive or malignant soft tissue tumors treated by surgery, and were followed up to assess recurrences. RESULTS: Subtraction MRI characterized recurrences better than routine sequences in 10 patients (1 lesion was seen only with this technique, 6 were better delineated, and 3 inflammatory pseudotumors were identified), and less well in 4 cases. CONCLUSION: As the number of levels studied on dynamic images is limited, and all but one recurrence were detected on T2-weighted images, it remains logical to start the examination with T2-weighted spin-echo images, and to use the dynamic study only if contrast injection is required.

Adult↗
PubMed1998

MRI of bone metastases.

Some knowledge of MR theory is required to be able to achieve high contrast between bone metastases and normal marrow. Three factors are used in MR to diagnose bone metastases; fat-water distribution, artifacts induced by bone trabeculae, and uptake of contrast medium. Using MR-histological correlations based on specimens of the lumbar spine, and studies of patients, we explain the advantages and limitations of sequences studying fat and water (spin-echo T1, STIR, in- and out-of-phase gradient echo, fat presaturation), bone trabeculae (gradient echo with long TE), and the injection of contrast medium.

Adipose Tissue↗
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↗