[Imaging and cancers].
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Decision Making↗
Biomedical subjects
Luc Ceugnart
Publications and source records attributed to Luc Ceugnart.
[Interest of imaging for the monitoring of a treated cancer: simplified use of likelyhood ratio. The example of soft tissue tumor].
Systematic follow-up of patients after initial treatment of cancer is stressful with heavy cost. The aim of such follow-up is to detect asymptomatic lesions in viewing to increase global survival and quality of life. For an individual patient, the issue of cancer recurrence is a binary event. However, when developing surveillance strategies for large groups of patients, knowledge of the risks (tumor biology, natural history of the disease), the benefits (potential efficacy of salvage therapy) and diagnosis test performances is necessary to formulate a rationale and resource effective follow-up algorithm. The Bayes'nomogram is useful to assess diagnosis test. Soft tissue sarcoma is a example of such demonstration.
Bayes Theorem↗
[Frequency of genetic diseases and cancer antecedents in 493 adults with visceral or soft tissue sarcomas].
Little is known about epidemiology of adults soft tissue and visceral sarcomas (ASTS). The frequency of previous cancers and associated genetic diseases has been analyzed out of 493 ASTS, treated between 1997 and 2002 at Oscar Lambret Cancer Center. Median age is 51, sex ratio is close to 1. Liposarcomas and malignant fibrous histiocytofibromas are the two main types (respectively 104 and 86 cases). Upper and lower limbs are the two main locations (respectively 176 and 75 cases). Fifteen patients had associated genetic disease, including 12 cases of Recklinghausen diseases. 7 out of those 15 patients have neurosarcoma. 30 patients have previous cancers, including 7 breast cancers, 3 lymphomas and 3 chronic lymphocytic leukemias. Four out of those 30 patients have two different previous cancers. 13 patients have radiation-induced sarcomas, after an average 10-year-period, and an average dose of 53 Gy. Undifferenciated sarcomas are the main histologic type (8/13), followed by angiosarcomas (2/13). Radiation-induced sarcomas are located in the chest wall (7/13), in pelvis (2/13) and head and neck (2/13). Those sarcomas are high grade (10 grade III tumours). ASTS epidemiology is complex with different risk factors depending on histologic type.
Adolescent↗
[MR imaging of endometrial carcinoma: role and limits].
PURPOSE: To assess the MR imaging (MRI) in initial decision making of endometrial carcinoma. PATIENTS AND METHODS: From january 1997 to march 2002, 86 patients with clinical stage I endometrial carcinoma were studied by pelvic (22) or abdomino-pelvic (64) MRI. The size and signal of lesions and junctional zone, the enhancement after contrast administration, the associated benign lesions and the pelvic and lumbo-aortic lymph nodes were assessed without knowledge of surgical results in viewing to identify pitfalls in MRI staging. RESULTS: MRI allows correct staging in 81.4% (70/86) of cases. Nine cases of false negative on T2 weighted images were correctly staged after contrast administration and dynamic study. Limits of MRI are due to presence of thin or lack of junctional zone, polyps, myomas, adenomyosis, intra cavitary bleeding, and myometrium thinning by large tumors. Eighteen patients were N+, with MRI sensitivity of 82% and specificity of 94%. CONCLUSION: MRI is the best modality for pretherapeutic assessment of endometrial carcinoma. MRI allows to choose type of surgery: laparoscopy or laparotomy and define volume of radiotherapy.
Adult↗