Biomedical subjects

Françoise Montravers

Publications and source records attributed to Françoise Montravers.

25 records · Page 2Linked to original sources

PubMed2003

Positron emission tomography with [(18)F]FDOPA and [(18)F]FDG in the imaging of small cell lung carcinoma: preliminary results.

Small cell lung carcinomas (SCLC) express neuroendocrine markers, and dihydroxyphenylalanine (DOPA) is known to accumulate in neuroendocrine tumours. This study was performed with the aim of evaluating the uptake of 3,4-dihydroxy-6-(18)F-fluoro-phenylalanine ([(18)F]FDOPA) by SCLC, based on comparison with the results of fluorine-18 fluorodeoxyglucose ([(18)F]FDG) positron emission tomography (PET) and standard imaging procedures. [(18)F]FDG PET and [(18)F]FDOPA PET were performed on four patients with newly diagnosed SCLC. There was agreement between the results of [(18)F]FDOPA PET and [(18)F]FDG PET in four tumoural sites out of 11, whereas [(18)F]FDG PET and standard imaging procedures were in full agreement. A semi-quantitative analysis based on standardised uptake values (SUVs) was performed in order to compare [(18)F]FDG and [(18)F]FDOPA tumour uptake. The median [(18)F]FDG SUV(max) was 5.9 (with a 95% confidence interval from 4.4 to 9.2), while the median [(18)F]FDOPA SUV(max) was 1.9 (with a 95% confidence interval from 1.6 to 3.8). The difference between [(18)F]FDG SUV(max) and [(18)F]FDOPA SUV(max) was significant ( P<0.01). [(18)F]FDOPA PET appeared less sensitive than [(18)F]FDG PET and standard imaging procedures in the staging of SCLC. No clear relation between [(18)F]FDOPA uptake and positivity of neuroendocrine markers on immunohistochemistry emerged from these preliminary results; however, since [(18)F]FDOPA uptake may reflect better differentiation of the tumour, and possibly a better prognosis, this point warrants clarification in a larger study.

Adult↗

PubMed2003

Diffusely increased F-18 FDG uptake in bone marrow in a patient with acute anemia and recent erythropoietin therapy.

Diffuse uptake of F-18 fluorodeoxyglucose (FDG) by the whole skeleton has been described in case of bone marrow stimulation resulting from treatment with colony-stimulating factors (CSFs): granulocyte CSF or granulocyte-macrophage CSF. The authors describe such an aspect of diffuse FDG uptake by the bone marrow during the follow-up of rectal cancer in a patient with anemia and recently treated thrice weekly by erythropoietin. To their knowledge, such an aspect of diffuse FDG uptake by the skeleton, revealing the bone marrow stimulation by erythropoietin, has not yet been reported.

Anemia↗

PubMed2003

Evaluation of fluorodeoxyglucose positron emission tomography in the detection of axillary lymph node metastases in patients with early-stage breast cancer.

BACKGROUND: The aim of this study was to assess the capacity of positron emission tomography (PET) with fluorodeoxyglucose (FDG) to determine axillary lymph node status in patients with breast cancer undergoing sentinel node (SN) biopsy. METHODS: Thirty-two patients with breast cancer and clinically negative axillary nodes were recruited. All patients underwent FDG-PET before SN biopsy. After SN biopsy, all patients underwent complete axillary lymph node (ALN) dissection. RESULTS: The SNs were identified in all patients. Fourteen patients (43.8%) had metastatic SNs (macrometastatic in seven, micrometastatic in six, and isolated tumor cells in one). The false-negative rate of SN biopsy was 6.6% (1 in 15). FDG-PET identified lymph node metastases in 3 of the 14 patients with positive SNs. The overall sensitivity, specificity, and positive and negative predictive values of FDG-PET in the diagnosis of axillary metastasis were 20%, 100%, 100%, and 58.6%, respectively. No false-positive findings were obtained with FDG-PET. CONCLUSIONS: This study demonstrates the limitations of FDG-PET in the detection of ALN metastases in patients with early breast cancer. In contrast, FDG-PET seems to be a specific method for staging the axilla in breast cancer. SN biopsy can be avoided in patients with positive FDG-PET, in whom complete ALN dissection should be the primary procedure.

Adult↗

PubMed2002

Fluorodeoxyglucose imaging using a coincidence gamma camera to detect head and neck squamous cell carcinoma and response to chemotherapy.

This prospective study was performed to evaluate the ability of a dual-head gamma camera with fluorine-18 fluorodeoxyglucose coincidence detection emission tomography (FDG-CDET) to detect primary tumor and cervical lymph nodes in head and neck squamous cell carcinoma (HNSCC), and to show the response of the carcinoma to chemotherapy. The findings were compared with those of physical examination, computed tomography (CT), and histopathology, before treatment in 61 patients, and after induction chemotherapy in 34 of them. Before treatment, the primary was detected in 93%, 79%, and 95% of cases on panendoscopy, CT, and FDG-CDET, respectively. After chemotherapy, 34 patients were evaluable for response of the primary tumor. Surgical resection was performed in 23 of them: agreement with histopathologic results for response to treatment was 74%, 69%, and 78% for panendoscopy, CT, and FDG-CDET, respectively. No surgical resection was performed in 11 of the 34 patients, but biopsies were performed before radiotherapy, and their rates of agreement with histopathologic results for response to treatment were 75%, 75%, and 67% on panendoscopy, CT, and FDG-CDET, respectively. For cervical lymph nodes, 245 sites were resected in 41 patients, and FDG-CDET appeared competitive with CT in detecting metastatic neck disease, especially after neoadjuvant chemotherapy; the accuracy was 93%. These results demonstrated the ability of FDG-CDET to detect primary tumors and cervical lymph nodes in HNSCC and to show its response to chemotherapy, as compared to the ability of CT and panendoscopy. It may be a complementary tool to evaluate residual disease after induction chemotherapy, although higher sensitivity would be required for FDG-CDET to be considered as a staging modality.

Carcinoma, Squamous Cell↗

PubMed2002

[18 F-fluorodeoxyglucose positron emission tomography for characterization and initial staging of pancreatic tumors].

AIM: To evaluate positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) for characterizing and initial staging of pancreatic tumors and to determine its impact on therapeutic strategy. PATIENTS AND METHODS: This study included 24 patients with pancreatic tumor who underwent PET before treatment. Twenty-two patients had a malignant tumor and two had a benign tumor. The PET scan was performed after intravenous injection of FDG with a gamma camera. PET findings were compared with histology of the pancreatic tumor (n=24), liver metastases (n=5), peritoneal metastases (n=5), and lymph node metastases (n=5). Absence of metastasis or lymph node involvement was determined by surgery or by CT scan, ultrasonography, magnetic resonance imaging and at least two months follow-up. RESULTS: The sensitivity of the PET scans to identify pancreatic carcinoma was 64% (95% confidence interval 44-84%). PET scans could not be interpreted for lymph node involvement adjacent to the tumor. For liver metastases, the PET scan was positive in 3 out of 5 patients. For peritoneal metastases, the PET scan was positive in 4 out of 5 patients but was doubtful in one. There were two false positives. Among the 4 cystic tumors, the PET scan was positive for 2 malignant tumors and negative for 2 benign tumors. Surgical strategy was modified in only one of the 24 patients on the basis of PET findings. CONCLUSION: The sensitivity of PET for the diagnosis of primary malignant pancreatic tumor was found to be low. The contribution of FDG-PET to the surgical decision appears to be limited to the detection of metastases or lymph node involvement distant from the tumor, contraindicating surgery. Nevertheless, the sensitivity of FDG-PET is lower than that of laparoscopy for peritoneal metastases. Indications for PET should be included in an evaluation of therapeutic decision making and cost analysis.

Adult↗

PubMedDate not supplied

[Correlation in imaging techniques for the early detection of bone metastases in a case of breast cancer].

The presented case is part of a pilot study performed in the Biophysics and Nuclear Medicine Service from the Tenon Hospital (Paris), chief Department Prof. J.N. Talbot. A 46 years patient, with mastectomy for a left breast cancer in 1999, followed by radiotherapy, is detected, in January 2004, through CT scan, with a tumoral mass at the left thoracic base. To confirm the rib osteolysis hypothesis a standard Rx was done; the result was the detection of a pathologic IX left rib fracture and a lacuna site on the L1 vertebra. The following bone scintigraphy make evidence of two hot spots (rib and vertebra) and also of a new pathologic site on the sternum. An 18FFDG PET image detects, despite the three known sites, another one on the left iliac bone crest. In conclusion, an extensive scintigraphic examination, including PET, is necessary to optimize the osteofil cancer metastases detection.

Bone Neoplasms↗

PubMedDate not supplied

[Role of radioisotopic investigations in breast cancer diagnosis and follow-up].

Breast cancer represents the disease with the highest incidence in the female population. In the last years there was observed, in western countries, an increase of morbidity by breast tumors and in the same time, a decrease of mortality in direct relation with an earlier diagnosis. Until the spread at distance, breast cancer it's a loco-regional disease that can be curable by surgical treatment and adjuvant therapy, like chemotherapy or radiotherapy. The principal goal is to diagnose it before distal metastases appear, most frequently bone metastasis. Certain role has nuclear medicine in the diagnosis and prognosis of breast cancer because it's more sensitive and gives functional imaging. The aim of this study is to answer the question: what technique, in what indication. The detection of sentinel lymph node has now a clear place in the algorithm, the scintimammography test is important, especially for prediction of tumor resistance to chemotherapy. The bone scintigraphy (which explores the entire body in one time)is generally used in the detection of bony metastases and FDG tomoscintigraphy for the evaluation of local and distal recurrences, or response to chemotherapy. The measure of the isotopic ejection fraction, actually considered the gold standard, is very useful and also very easy to perform, in patients who will receive chemotherapy.

Bone Neoplasms↗