29 results on '"S. Montagne"'
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2. Five simultaneous artificial intelligence data challenges on ultrasound, CT, and MRI
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B. Bresson, N. Poussange, M. Majer, Marc Zins, D. Guenoun, Olivier Hauger, S. Si-Mohamed, D. Istrati, Théo Estienne, M. Azoulay, S. Molière, Nathalie Lassau, E. Jehanno, C. Balleyguier, Caroline Caramella, A. Bergère, M. Boisserie, J. Behr, F. Dubrulle, J.-F. Meder, François Cornelis, E. Poncelet, A. Paisant, Raphaëlle Renard-Penna, N. Peyron Faure, H. Cauliez, Caroline Malhaire, T. Caramella, A. Perrey, P. de Vomecourt, François Bidault, C. Bordonne, S. Montagne, Alain Luciani, S. Caius Giurca, G. Garcia, M. Faivre-Pierre, Nicolas Amoretti, F. Desmots, Anne Cotten, M. Abitbol, V. Herreros, Aurélie Jalaguier-Coudray, Olivier Rouvière, J.-F. Budzik, J. Cagnol, Laure Fournier, Valérie Juhan, M. Faruch, C. Cyteval, T. Jacques, J. Bocquet, R. Lotte, T. Willaume, J.-L. Drape, S. Brunelle, A. Blum, M. Garetier, L. Di Marco, F. Pigneur, Institut Gustave Roussy (IGR), Imagerie multimodale en cancérologie. (IR4M/U8081 éq.3), Institut Gustave Roussy (IGR)-Imagerie par Résonance Magnétique Médicale et Multi-Modalités (IR4M), Université Paris-Sud - Paris 11 (UP11)-Hôpital Bicêtre-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Bicêtre-Centre National de la Recherche Scientifique (CNRS), Direction de la recherche [Gustave Roussy], Radiothérapie Moléculaire et Innovation Thérapeutique (RaMo-IT), Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Direction de la Transformation Numérique et des Systèmes d’Information, Mathématiques et Informatique pour la Complexité et les Systèmes (MICS), CentraleSupélec-Université Paris-Saclay, Comité de Cancérologie (CCAFU), Association Française d'Urologie, Département de radiothérapie [Gustave Roussy], Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultations et d’Imagerie de l’Appareil Locomoteur, Service de Radiologie (LILLE - Radio), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de radiologie [CHRU Besancon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Clinique du sport de Bordeaux-Mérignac, Clinique Saint-Jean - Toulon, Polytech'Paris - Sorbonne Université, Sorbonne Université (SU), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre Hospitalier Universitaire de Nice (CHU Nice), inconnu temporaire UPEMLV, Inconnu, Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], CHU Pontchaillou [Rennes], Application des ultrasons à la thérapie (LabTAU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre de résonance magnétique des systèmes biologiques (CRMSB), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Hôpital d'Instruction des Armées Clermont Tonnerre, Service de Santé des Armées, Hôpital Henri Mondor, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Radiology, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Lyon, Hôpital Cochin [AP-HP], Service Imagerie de la femme, CH de Valenciennes, Hôpital Hôtel-Dieu [Paris], Centre Hospitalier de Lens, Université catholique de Lille (UCL), Institut Bergonié [Bordeaux], UNICANCER, Hôpital de Hautepierre [Strasbourg], Clinique du Val d'Ouest, Centre d’ Imagerie du Chinonais, Hôpital Européen [Fondation Ambroise Paré - Marseille], Institut du Sein, Service de Génétique Médicale [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Pathologie Infectieuse et Tropicale [HIA Laveran, Marseille], Hôpital d'instruction des armées Laveran, Clinique du Pont Saint-Vaast, Douai, Centre d'Etudes et de Recherche Thérapeutique en Ophtalmologie (CERTO), Association RETINA France, Partenaires INRAE-Partenaires INRAE, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Département de Radiologie, Armentières (59), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Institut des Sciences du Mouvement Etienne Jules Marey (ISM), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Sciences pour l'environnement (SPE), Université Pascal Paoli (UPP)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier Saint-Joseph [Paris], Service de neuroradiologie [Paris], Hôpital Sainte-Anne, Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490 (MABLab (ex-pmoi)), Université du Littoral Côte d'Opale (ULCO)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Radiologie Viscèrale, CHRU de Jean-Minjoz, CHU Toulouse [Toulouse], Service de radiologie et imagerie médicale [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM), Résonance magnétique des systèmes biologiques (RMSB), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), CHU Clermont-Ferrand, Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Centre National de la Recherche Scientifique (CNRS)-Université Pascal Paoli (UPP), Groupe hospitalier Paris Saint-Joseph - Hôpital, Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CCSD, Accord Elsevier, Imagerie par Résonance Magnétique Médicale et Multi-Modalités (IR4M), Centre National de la Recherche Scientifique (CNRS)-Hôpital Bicêtre-Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Bicêtre-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR), and Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB)
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Kidney Cortex ,[SPI] Engineering Sciences [physics] ,Interprofessional Relations ,education ,Meniscal tears ,Datasets as Topic ,Computed tomography ,Breast Neoplasms ,Artificial intelligence (AI) ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,[SPI]Engineering Sciences [physics] ,0302 clinical medicine ,Multidisciplinary approach ,Artificial Intelligence ,Ultrasound ,Medicine ,Data Protection Act 1998 ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Invasiveness ,Thyroid Neoplasms ,Magnetic resonance imaging (MRI) ,Computer Security ,Ultrasonography ,Modalities ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Communication ,Liver Neoplasms ,Computed Tomography (CT) ,Deep learning ,General Medicine ,Magnetic Resonance Imaging ,Tibial Meniscus Injuries ,030220 oncology & carcinogenesis ,General Data Protection Regulation ,Thyroid Cartilage ,Artificial intelligence ,business ,Tomography, X-Ray Computed - Abstract
Summary Purpose The goal of this data challenge was to create a structured dynamic with the following objectives: (1) teach radiologists the new rules of General Data Protection Regulation (GDPR), while building a large multicentric prospective database of ultrasound, computed tomography (CT) and MRI patient images; (2) build a network including radiologists, researchers, start-ups, large companies, and students from engineering schools, and; (3) provide all French stakeholders working together during 5 data challenges with a secured framework, offering a realistic picture of the benefits and concerns in October 2018. Materials and methods Relevant clinical questions were chosen by the Societe Francaise de Radiologie. The challenge was designed to respect all French ethical and data protection constraints. Multidisciplinary teams with at least one radiologist, one engineering student, and a company and/or research lab were gathered using different networks, and clinical databases were created accordingly. Results Five challenges were launched: detection of meniscal tears on MRI, segmentation of renal cortex on CT, detection and characterization of liver lesions on ultrasound, detection of breast lesions on MRI, and characterization of thyroid cartilage lesions on CT. A total of 5,170 images within 4 months were provided for the challenge by 46 radiology services. Twenty-six multidisciplinary teams with 181 contestants worked for one month on the challenges. Three challenges, meniscal tears, renal cortex, and liver lesions, resulted in an accuracy > 90%. The fourth challenge (breast) reached 82% and the lastone (thyroid) 70%. Conclusion Theses five challenges were able to gather a large community of radiologists, engineers, researchers, and companies in a very short period of time. The accurate results of three of the five modalities suggest that artificial intelligence is a promising tool in these radiology modalities.
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- 2019
3. Kidney cortex segmentation in 2D CT with U-Nets ensemble aggregation
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Nicolas Villain, Olivier Pierre Nempont, Marie-France Bellin, Loic Boussel, Isabelle Bloch, Raphaëlle Renard-Penna, V. Couteaux, J. Behr, Guillaume Julien Joseph Pizaine, S. Montagne, Alexandre Popoff, Salim Si-Mohamed, Catherine Roy, T. Lefevre, Olivier Rouvière, Nathalie Lassau, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Radiologie [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de radiologie [CHRU Besancon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Imagerie par Résonance Magnétique Médicale et Multi-Modalités (IR4M), and Centre National de la Recherche Scientifique (CNRS)-Hôpital Bicêtre-Université Paris-Sud - Paris 11 (UP11)
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Kidney Cortex ,[SDV]Life Sciences [q-bio] ,Datasets as Topic ,Dice ,030218 nuclear medicine & medical imaging ,Set (abstract data type) ,03 medical and health sciences ,0302 clinical medicine ,Artificial Intelligence ,Cortex (anatomy) ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Segmentation ,Radiological and Ultrasound Technology ,business.industry ,Aggregate (data warehouse) ,Pattern recognition ,General Medicine ,Image segmentation ,medicine.anatomical_structure ,Ranking ,030220 oncology & carcinogenesis ,Artificial intelligence ,business ,Tomography, X-Ray Computed ,Algorithms ,Volume (compression) - Abstract
Purpose This work presents our contribution to one of the data challenges organized by the French Radiology Society during the Journees Francophones de Radiologie. This challenge consisted in segmenting the kidney cortex from coronal computed tomography (CT) images, cropped around the cortex. Materials and methods We chose to train an ensemble of fully-convolutional networks and to aggregate their prediction at test time to perform the segmentation. An image database was made available in 3 batches. A first training batch of 250 images with segmentation masks was provided by the challenge organizers one month before the conference. An additional training batch of 247 pairs was shared when the conference began. Participants were ranked using a Dice score. Results The segmentation results of our algorithm match the renal cortex with a good precision. Our strategy yielded a Dice score of 0.867, ranking us first in the data challenge. Conclusion The proposed solution provides robust and accurate automatic segmentations of the renal cortex in CT images although the precision of the provided reference segmentations seemed to set a low upper bound on the numerical performance. However, this process should be applied in 3D to quantify the renal cortex volume, which would require a marked labelling effort to train the networks.
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- 2019
4. Comment prévenir la morbidité chirurgicale de la thyroïdectomie totale pour goitre multinodulaire euthyroïdien ?
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Patrick Boissel, Laurent Bresler, Laurent Brunaud, J. M. Tortuyaux, Ahmet Ayav, and S Montagne
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Surgery ,business - Abstract
Resume But de l’etude : La thyroidectomie totale a ete proposee comme traitement initial des goitres multinodulaires euthyroidiens benins. Le but de cette etude est de determiner, a partir de notre experience, les moyens permettant de prevenir la morbidite liee a cette intervention. Materiel et methode : Nous analysons retrospectivement une serie de patients operes d’une thyroidectomie totale pour goitre multinodulaire bilateral euthyroidien entre janvier 1996 et septembre 2000 dans le service de chirurgie C (chirurgie generale et digestive) du CHU de Nancy. Nous avons recherche la morbidite specifique liee a ce geste, au moyen de controles cliniques et biologiques systematiques. Resultats : Notre serie comprend 64 patients, dont 51 femmes (79,7 %) et 13 hommes (20,3 %). L’âge moyen etait de 47 ans (22–76 ans). La morbidite recurrentielle a concerne deux patients, sous forme d’une atteinte unilaterale provisoire (1,6 %) et d’une atteinte unilaterale definitive (1,6 %). Deux atteintes provisoires (3,2 %) et une atteinte definitive (1,6 %) de la branche externe du nerf larynge superieur ont ete suspectees cliniquement. Huit patients (12,5 %) ont presente une hypoparathyroidie transitoire. Une patiente (1,6 %) presente une hypoparathyroidie definitive. Conclusion : La morbidite apres thyroidectomie totale pour goitre multinodulaire euthyroidien benin dans notre etude est comparable aux donnees fournies par la litterature apres thyroidectomie totale ou subtotale. La morbidite peut etre prevenue par l’identification systematique du nerf recurrent, et par une strategie operatoire ayant pour but le respect de la vascularisation parathyroidienne.
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- 2002
5. [How to prevent surgical morbidity after a total thyroidectomy for a multinodular euthyroid goiter?]
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S, Montagne, L, Brunaud, L, Bresler, A, Ayav, J M, Tortuyaux, and P, Boissel
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Adult ,Male ,Treatment Outcome ,Hypocalcemia ,Thyroidectomy ,Humans ,Female ,Middle Aged ,Morbidity ,Vocal Cord Paralysis ,Aged ,Goiter, Nodular ,Retrospective Studies - Abstract
Total thyroidectomy has been advocated for the treatment of multinodular nontoxic and benign goiter. The aim of this study, based on our experience, was to define the surgical factors which permit to decrease morbidity related to total thyroidectomy for multinodular euthyroid benign goiter.In a retrospective study performed between January 1996 and September 2000, all records of total thyroidectomy for initial treatment of multinodular euthyroid benign goiter were reviewed. This study allowed to specify recurrent and parathyroid morbidity after surgery.There were 51 women and 13 men with a mean age of 47 years. Recurrent laryngeal nerve injury occurred in 2 patients. It resolved in 1 patient but was permanent in another (1.6%). Transient hypocalcemia was found in 8 patients (12.5%). One patient had permanent hypocalcemia (1.6%).The results of our serie are comparable to previous reports. Systematic identification of the recurrent laryngeal nerve, and preservation of the parathyroid blood supply permit to decrease the surgical morbidity.
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- 2002
6. Diurnal preference, mood and the response to morning light in relation to polymorphisms in the human clock gene PER3
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M. Turco, A. Biscontin, M. Corrias, L. Caccin, M. Bano, F. Chiaromanni, M. Salamanca, D. Mattei, C. Salvoro, G. Mazzotta, C. De Pittà, B. Middleton, D. J. Skene, S. Montagnese, and R. Costa
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Medicine ,Science - Abstract
Abstract PER3 gene polymorphisms have been associated with differences in human sleep-wake phenotypes, and sensitivity to light. The aims of this study were to assess: i) the frequency of allelic variants at two PER3 polymorphic sites (rs57875989 length polymorphism: PER3 4, PER3 5; rs228697 SNP: PER3 C, PER3 G) in relation to sleep-wake timing; ii) the effect of morning light on behavioural/circadian variables in PER3 4 /PER3 4 and PER3 5 /PER3 5 homozygotes. 786 Caucasian subjects living in Northern Italy donated buccal DNA and completed diurnal preference, sleep quality/timing and sleepiness/mood questionnaires. 19 PER3 4 /PER3 4 and 11 PER3 5 /PER3 5 homozygotes underwent morning light administration, whilst monitoring sleep-wake patterns and the urinary 6-sulphatoxymelatonin (aMT6s) rhythm. No significant relationship was observed between the length polymorphism and diurnal preference. By contrast, a significant association was observed between the PER3 G variant and morningness (OR = 2.10), and between the PER3 G-PER3 4 haplotype and morningness (OR = 2.19), for which a mechanistic hypothesis is suggested. No significant differences were observed in sleep timing/aMT6s rhythms between PER3 5 /PER3 5 and PER3 4 /PER3 4 subjects at baseline. After light administration, PER3 4 /PER3 4 subjects advanced their aMT6s acrophase (p
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- 2017
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7. Reference standard for the evaluation of automatic segmentation algorithms: Quantification of inter observer variability of manual delineation of prostate contour on MRI.
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Molière S, Hamzaoui D, Granger B, Montagne S, Allera A, Ezziane M, Luzurier A, Quint R, Kalai M, Ayache N, Delingette H, and Renard-Penna R
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- Male, Humans, Observer Variation, Magnetic Resonance Imaging methods, Algorithms, Prostate diagnostic imaging, Artificial Intelligence
- Abstract
Purpose: The purpose of this study was to investigate the relationship between inter-reader variability in manual prostate contour segmentation on magnetic resonance imaging (MRI) examinations and determine the optimal number of readers required to establish a reliable reference standard., Materials and Methods: Seven radiologists with various experiences independently performed manual segmentation of the prostate contour (whole-gland [WG] and transition zone [TZ]) on 40 prostate MRI examinations obtained in 40 patients. Inter-reader variability in prostate contour delineations was estimated using standard metrics (Dice similarity coefficient [DSC], Hausdorff distance and volume-based metrics). The impact of the number of readers (from two to seven) on segmentation variability was assessed using pairwise metrics (consistency) and metrics with respect to a reference segmentation (conformity), obtained either with majority voting or simultaneous truth and performance level estimation (STAPLE) algorithm., Results: The average segmentation DSC for two readers in pairwise comparison was 0.919 for WG and 0.876 for TZ. Variability decreased with the number of readers: the interquartile ranges of the DSC were 0.076 (WG) / 0.021 (TZ) for configurations with two readers, 0.005 (WG) / 0.012 (TZ) for configurations with three readers, and 0.002 (WG) / 0.0037 (TZ) for configurations with six readers. The interquartile range decreased slightly faster between two and three readers than between three and six readers. When using consensus methods, variability often reached its minimum with three readers (with STAPLE, DSC = 0.96 [range: 0.945-0.971] for WG and DSC = 0.94 [range: 0.912-0.957] for TZ, and interquartile range was minimal for configurations with three readers., Conclusion: The number of readers affects the inter-reader variability, in terms of inter-reader consistency and conformity to a reference. Variability is minimal for three readers, or three readers represent a tipping point in the variability evolution, with both pairwise-based metrics or metrics with respect to a reference. Accordingly, three readers may represent an optimal number to determine references for artificial intelligence applications., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest related to this work to declare., (Copyright © 2023 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)
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- 2024
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8. Clinical performance of magnetic resonance imaging and biomarkers for prostate cancer diagnosis in men at high genetic risk.
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Cussenot O, Renard-Penna R, Montagne S, Ondet V, Pilon A, Guechot J, Comperat E, Hamdy F, Lamb A, and Cancel-Tassin G
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- Male, Humans, Adult, Prostate diagnostic imaging, Prostate pathology, Magnetic Resonance Imaging methods, Prostate-Specific Antigen, Bayes Theorem, Biomarkers, Image-Guided Biopsy methods, Retrospective Studies, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms genetics
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Objectives: To evaluate different scenarios for the management of early diagnosis of cancer (PCa) in men at high genetic risk, using recently developed blood and urinary molecular biomarkers in combination with clinical information alongside multiparametric magnetic resonance imaging (mpMRI)., Patients and Methods: A total of 322 patients with a high genetic risk (familial or personal history of cancers or a predisposing germline variant) were included in this study. The primary outcome was the detection rates of PCa (positive biopsy) or clinically significant PCa (biopsy with International Society of Urological Pathology [ISUP] grade >1). Clinical parameters included age, body mass index, ancestry, and germline mutational status, mpMRI, prostate-specific antigen density (PSAD), Prostate Health Index and urinary markers (Prostate Cancer Associated 3, SelectMdx™ and T2:ERG score) were assessed. Sensitivity (Se) and specificity (Sp) for each marker at their recommended cut-off for clinical practice were calculated. Comparison between diagnoses accuracy of each procedure and scenario was computed using mutual information based and direct effect contribution using a supervised Bayesian network approach., Results: A mpMRI Prostate Imaging-Reporting and Data System (PI-RADS) score ≥3 showed higher Se than mpMRI PI-RADS score ≥4 for detection of PCa (82% vs 61%) and for the detection of ISUP grade >1 lesions (96% vs 80%). mpMRI PI-RADS score ≥3 performed better than a PSA level of ≥3 ng/mL (Se 96%, Sp 53% vs Se 91%, Sp 8%) for detection of clinically significant PCa. In case of negative mpMRI results, the supervised Bayesian network approach showed that urinary markers (with the same accuracy for all) and PSAD of ≥0.10 ng/mL/mL were the most useful indicators of decision to biopsy., Conclusions: We found that screening men at high genetic risk of PCa must be based on mpMRI without pre-screening based on a PSA level of >3 ng/mL, to avoid missing too many ISUP grade >1 tumours and to significantly reduce the number of unnecessary biopsies. However, urinary markers or a PSAD of ≥0.10 ng/mL/mL when mpMRI was negative increased the detection of ISUP grade >1 cancers. We suggest that a baseline mpMRI be discussed for men at high genetic risk from the age of 40 years., (© 2023 BJU International.)
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- 2023
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9. Automatic segmentation of prostate zonal anatomy on MRI: a systematic review of the literature.
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Wu C, Montagne S, Hamzaoui D, Ayache N, Delingette H, and Renard-Penna R
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Objectives: Accurate zonal segmentation of prostate boundaries on MRI is a critical prerequisite for automated prostate cancer detection based on PI-RADS. Many articles have been published describing deep learning methods offering great promise for fast and accurate segmentation of prostate zonal anatomy. The objective of this review was to provide a detailed analysis and comparison of applicability and efficiency of the published methods for automatic segmentation of prostate zonal anatomy by systematically reviewing the current literature., Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was conducted until June 30, 2021, using PubMed, ScienceDirect, Web of Science and EMBase databases. Risk of bias and applicability based on Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) criteria adjusted with Checklist for Artificial Intelligence in Medical Imaging (CLAIM) were assessed., Results: A total of 458 articles were identified, and 33 were included and reviewed. Only 2 articles had a low risk of bias for all four QUADAS-2 domains. In the remaining, insufficient details about database constitution and segmentation protocol provided sources of bias (inclusion criteria, MRI acquisition, ground truth). Eighteen different types of terminology for prostate zone segmentation were found, while 4 anatomic zones are described on MRI. Only 2 authors used a blinded reading, and 4 assessed inter-observer variability., Conclusions: Our review identified numerous methodological flaws and underlined biases precluding us from performing quantitative analysis for this review. This implies low robustness and low applicability in clinical practice of the evaluated methods. Actually, there is not yet consensus on quality criteria for database constitution and zonal segmentation methodology., (© 2022. The Author(s).)
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- 2022
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10. Prostate volume prediction on MRI: tools, accuracy and variability.
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Hamzaoui D, Montagne S, Granger B, Allera A, Ezziane M, Luzurier A, Quint R, Kalai M, Ayache N, Delingette H, and Renard-Penna R
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- Humans, Magnetic Resonance Imaging methods, Male, Reproducibility of Results, Prostate diagnostic imaging, Prostatic Neoplasms diagnostic imaging
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Objective: A reliable estimation of prostate volume (PV) is essential to prostate cancer management. The objective of our multi-rater study was to compare intra- and inter-rater variability of PV from manual planimetry and ellipsoid formulas., Methods: Forty treatment-naive patients who underwent prostate MRI were selected from a local database. PV and corresponding PSA density (PSAd) were estimated on 3D T2-weighted MRI (3 T) by 7 independent radiologists using the traditional ellipsoid formula (TEF), the newer biproximate ellipsoid formula (BPEF), and the manual planimetry method (MPM) used as ground truth. Intra- and inter-rater variability was calculated using the mixed model-based intraclass correlation coefficient (ICC)., Results: Mean volumes were 67.00 (± 36.61), 66.07 (± 35.03), and 64.77 (± 38.27) cm
3 with the TEF, BPEF, and MPM methods, respectively. Both TEF and BPEF overestimated PV relative to MPM, with the former presenting significant differences (+ 1.91 cm3 , IQ = [- 0.33 cm3 , 5.07 cm3 ], p val = 0.03). Both intra- (ICC > 0.90) and inter-rater (ICC > 0.90) reproducibility were excellent. MPM had the highest inter-rater reproducibility (ICC = 0.999). Inter-rater PV variation led to discrepancies in classification according to the clinical criterion of PSAd > 0.15 ng/mL for 2 patients (5%), 7 patients (17.5%), and 9 patients (22.5%) when using MPM, TEF, and BPEF, respectively., Conclusion: PV measurements using ellipsoid formulas and MPM are highly reproducible. MPM is a robust method for PV assessment and PSAd calculation, with the lowest variability. TEF showed a high degree of concordance with MPM but a slight overestimation of PV. Precise anatomic landmarks as defined with the BPEF led to a more accurate PV estimation, but also to a higher variability., Key Points: • Manual planimetry used for prostate volume estimation is robust and reproducible, with the lowest variability between readers. • Ellipsoid formulas are accurate and reproducible but with higher variability between readers. • The traditional ellipsoid formula tends to overestimate prostate volume., (© 2022. The Author(s), under exclusive licence to European Society of Radiology.)- Published
- 2022
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11. Correction to: Prostate volume prediction on MRI: tools, accuracy and variability.
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Hamzaoui D, Montagne S, Granger B, Allera A, Ezziane M, Luzurier A, Quint R, Kalai M, Ayache N, Delingette H, and Renard-Penna R
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- 2022
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12. Robust Bayesian fusion of continuous segmentation maps.
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Audelan B, Hamzaoui D, Montagne S, Renard-Penna R, and Delingette H
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- Bayes Theorem, Humans, Male, Probability, Algorithms, Magnetic Resonance Imaging methods
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The fusion of probability maps is required when trying to analyse a collection of image labels or probability maps produced by several segmentation algorithms or human raters. The challenge is to weight the combination of maps correctly, in order to reflect the agreement among raters, the presence of outliers and the spatial uncertainty in the consensus. In this paper, we address several shortcomings of prior work in continuous label fusion. We introduce a novel approach to jointly estimate a reliable consensus map and to assess the presence of outliers and the confidence in each rater. Our robust approach is based on heavy-tailed distributions allowing local estimates of raters performances. In particular, we investigate the Laplace, the Student's t and the generalized double Pareto distributions, and compare them with respect to the classical Gaussian likelihood used in prior works. We unify these distributions into a common tractable inference scheme based on variational calculus and scale mixture representations. Moreover, the introduction of bias and spatial priors leads to proper rater bias estimates and control over the smoothness of the consensus map. Finally, we propose an approach that clusters raters based on variational boosting, and thus may produce several alternative consensus maps. Our approach was successfully tested on MR prostate delineations and on lung nodule segmentations from the LIDC-IDRI dataset., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
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13. Diagnosis of early biochemical recurrence after radical prostatectomy or radiation therapy in patients with prostate cancer: State of the art.
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Zhang-Yin J, Montravers F, Montagne S, Hennequin C, and Renard-Penna R
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- Humans, Male, Neoplasm Recurrence, Local diagnostic imaging, Neoplasm Recurrence, Local pathology, Positron Emission Tomography Computed Tomography methods, Prostate-Specific Antigen, Prostatectomy methods, Prostate pathology, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms pathology, Prostatic Neoplasms radiotherapy
- Abstract
Biochemical recurrence after primary treatment in prostate cancer is not uncommon. A rising serum prostate-specific antigen level represents a first sign of disease relapse. At this time of low disease burden, imaging and particularly magnetic resonance imaging and positron emission tomography/computed tomography (PET/CT) are essential to determine the localization of the recurrence, which may be local, in lymph nodes, and/or metastatic. Imaging results allow best determine modalities of salvage treatment, which can be local by using radiotherapy or other focal treatments or systemic using hormonotherapy. Current evidence suggests that multiparametric magnetic resonance imaging, PET/CT with prostate specific membrane antigen and lympho-magnetic resonance imaging are effective and complementary to detect local recurrences and distant metastases., Competing Interests: Disclosure of interest The authors declare that they have no competing of interest., (Copyright © 2022 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
- Published
- 2022
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14. Automatic zonal segmentation of the prostate from 2D and 3D T2-weighted MRI and evaluation for clinical use.
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Hamzaoui D, Montagne S, Renard-Penna R, Ayache N, and Delingette H
- Abstract
Purpose: An accurate zonal segmentation of the prostate is required for prostate cancer (PCa) management with MRI. Approach: The aim of this work is to present UFNet, a deep learning-based method for automatic zonal segmentation of the prostate from T2-weighted (T2w) MRI. It takes into account the image anisotropy, includes both spatial and channelwise attention mechanisms and uses loss functions to enforce prostate partition. The method was applied on a private multicentric three-dimensional T2w MRI dataset and on the public two-dimensional T2w MRI dataset ProstateX. To assess the model performance, the structures segmented by the algorithm on the private dataset were compared with those obtained by seven radiologists of various experience levels. Results: On the private dataset, we obtained a Dice score (DSC) of 93.90 ± 2.85 for the whole gland (WG), 91.00 ± 4.34 for the transition zone (TZ), and 79.08 ± 7.08 for the peripheral zone (PZ). Results were significantly better than other compared networks' ( p - value < 0.05 ). On ProstateX, we obtained a DSC of 90.90 ± 2.94 for WG, 86.84 ± 4.33 for TZ, and 78.40 ± 7.31 for PZ. These results are similar to state-of-the art results and, on the private dataset, are coherent with those obtained by radiologists. Zonal locations and sectorial positions of lesions annotated by radiologists were also preserved. Conclusions: Deep learning-based methods can provide an accurate zonal segmentation of the prostate leading to a consistent zonal location and sectorial position of lesions, and therefore can be used as a helping tool for PCa diagnosis., (© 2022 Society of Photo-Optical Instrumentation Engineers (SPIE).)
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- 2022
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15. Zonal anatomy of the prostate using magnetic resonance imaging, morphometrics, and radiomic features: impact of age-related changes.
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Laschkar S, Montagne S, De Kerviler E, Roupret M, Lucidarme O, Cussenot O, and Renard Penna R
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- Adult, Age Factors, Aged, Aged, 80 and over, Entropy, Humans, Male, Middle Aged, Prostate-Specific Antigen blood, Retrospective Studies, Diffusion Magnetic Resonance Imaging methods, Prostate anatomy & histology
- Abstract
Objective: To evaluate the impact of age on the zonal anatomy of the prostate by MRI using morphometric and textural analysis., Methods: A total of 154 men (mean age: 63 years) who underwent MRI due to a high prostate-specific antigen (PSA) level were included retrospectively. At each MRI examination the following variables were measured: overall dimensions of the prostate (whole gland (WG), transitional zone (TZ), and peripheral zone (PZ)), and thickness of the anterior fibromuscular stroma (AFMS) and the periprostatic venous plexus (PPVP) on T
2 weighted images. Identical regions of interest (ROIs) were delineated on the apparent diffusion coefficient (ADC) map on the anterior (horn) and posterior part of the PZ. Textural (TexRAD® ) parameter differences between TZ and PZ ROIs on T2 weighted images were analyzed by linear regression. Results were correlated with age (distributed into five decades from 22 to 89 years)., Results: Age was positively correlated with PSA level and glandular volumes (WG, TZ, and TZ/WG ratio; p < 0.0001) and was negatively correlated with AFSM and PPVP thickness ( p < 0.0001). There was a positive correlation between ADC values of the PZ and age ( p = 0.003) and between entropy of the TZ and PZ and age ( p < 0.001)., Conclusion: Gradual variations in morphologic and textural features of the prostate were observed with age, mainly due to the increase in TZ volume while PZ volume tended to decrease. These modifications resulted in textural changes mainly at the expense of entropy., Advances in Knowledge: Entropy could be relevant for studying the process of aging of the prostate.- Published
- 2022
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16. Regulatory Flexibilities and Guidances for Addressing the Challenges of COVID-19 in the EU: What Can We Learn from Company Experiences?
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Klein K, Stolk P, Tellner P, Acha V, Montagne S, and Stöckert I
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- COVID-19 Vaccines, Drug Industry, Humans, Pandemics, SARS-CoV-2, COVID-19
- Abstract
The COVID-19 pandemic required urgency in the development and delivery of effective vaccines and therapeutics; meanwhile, ongoing clinical research, regulation and supply for other much-needed therapeutics and vaccines needed to be sustained. In Europe, the European Commission, the European Medicines Agency (EMA) and the national regulatory agencies (NRAs) responded by issuing guidance outlining regulatory flexibilities mainly directed at COVID-19 vaccines and, belatedly, therapeutics. Using a survey methodology, this study gathered the views of the R&D based pharmaceutical industry in May-June 2021 on the value of these flexibilities for continued use in the post-pandemic era as well as for future use in health emergency situations. Findings indicate that many flexibilities were foreseen to have value beyond the pandemic, particularly where EU and Member States aligned closely to provide a singular, streamlined regulatory environment. Digitalization was a notable driver of these flexibilities, but innovations in regulatory process (e.g. rolling reviews, flexible Scientific Advice) improved the process and outcomes measurably. Finally, the rapid reaction of the EU regulatory system and extensive efforts by all involved in providing innovative therapeutics and vaccines to patients in need provides learnings for the upcoming overhaul of the pharmaceutical acquis., (© 2022. The Drug Information Association, Inc.)
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- 2022
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17. Targeting Local Recurrence After Surgery With MRI Imaging for Prostate Cancer in the Setting of Salvage Radiation Therapy.
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Renard-Penna R, Zhang-Yin J, Montagne S, Aupin L, Bruguière E, Labidi M, Latorzeff I, and Hennequin C
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Magnetic resonance imaging (MRI) is being increasingly used for imaging suspected recurrence in prostate cancer therapy. Functional MRI with diffusion and perfusion imaging has the potential to demonstrate local recurrence even at low PSA value. Detection of recurrence can modify the management of postprostatectomy biochemical recurrence. MRI scan acquired before salvage radiotherapy is useful for the localization of recurrent tumors and also in the delineation of the target volume. The objective of this review is to assess the role and potential impact of MRI in targeting local recurrence after surgery for prostate cancer in the setting of salvage radiation therapy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Renard-Penna, Zhang-Yin, Montagne, Aupin, Bruguière, Labidi, Latorzeff and Hennequin.)
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- 2022
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18. Challenge of prostate MRI segmentation on T2-weighted images: inter-observer variability and impact of prostate morphology.
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Montagne S, Hamzaoui D, Allera A, Ezziane M, Luzurier A, Quint R, Kalai M, Ayache N, Delingette H, and Renard-Penna R
- Abstract
Background: Accurate prostate zonal segmentation on magnetic resonance images (MRI) is a critical prerequisite for automated prostate cancer detection. We aimed to assess the variability of manual prostate zonal segmentation by radiologists on T2-weighted (T2W) images, and to study factors that may influence it., Methods: Seven radiologists of varying levels of experience segmented the whole prostate gland (WG) and the transition zone (TZ) on 40 axial T2W prostate MRI images (3D T2W images for all patients, and both 3D and 2D images for a subgroup of 12 patients). Segmentation variabilities were evaluated based on: anatomical and morphological variation of the prostate (volume, retro-urethral lobe, intensity contrast between zones, presence of a PI-RADS ≥ 3 lesion), variation in image acquisition (3D vs 2D T2W images), and reader's experience. Several metrics including Dice Score (DSC) and Hausdorff Distance were used to evaluate differences, with both a pairwise and a consensus (STAPLE reference) comparison., Results: DSC was 0.92 (± 0.02) and 0.94 (± 0.03) for WG, 0.88 (± 0.05) and 0.91 (± 0.05) for TZ respectively with pairwise comparison and consensus reference. Variability was significantly (p < 0.05) lower for the mid-gland (DSC 0.95 (± 0.02)), higher for the apex (0.90 (± 0.06)) and the base (0.87 (± 0.06)), and higher for smaller prostates (p < 0.001) and when contrast between zones was low (p < 0.05). Impact of the other studied factors was non-significant., Conclusions: Variability is higher in the extreme parts of the gland, is influenced by changes in prostate morphology (volume, zone intensity ratio), and is relatively unaffected by the radiologist's level of expertise.
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- 2021
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19. Erratum to 'Prostate cancer local staging using biparametric MRI: Assessment and comparison with multiparametric MRI' [Eur. J. Radiol. 132 (2020) 109350].
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Christophe C, Montagne S, Bourrelier S, Roupret M, Barret E, Rozet F, Comperat E, Coté JF, Lucidarme O, Cussenot O, Granger B, and Renard-Penna R
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- 2020
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20. Prostate cancer local staging using biparametric MRI: assessment and comparison with multiparametric MRI.
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Christophe C, Montagne S, Bourrelier S, Roupret M, Barret E, Rozet F, Comperat E, Coté JF, Lucidarme O, Cussenot O, Granger B, and Renard-Penna R
- Subjects
- Aged, Humans, Male, Middle Aged, Prostatectomy, Prostatic Neoplasms surgery, Retrospective Studies, Multiparametric Magnetic Resonance Imaging, Neoplasm Staging methods, Prostatic Neoplasms diagnostic imaging
- Abstract
Purpose: The value of adding dynamic contrast-enhanced (DCE) imaging to T2-weighted (T2W) magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) to improve the detection and staging of prostate cancer (PCa) is unclear. The aim of this retrospective study was to compare the diagnostic performance of non-contrast biparametric MRI (bpMRI) with multiparametric MRI (mpMRI), for local staging of PCa., Methods: Ninety-two patients who underwent prostate MRI on a 3-Tesla MRI system before radical prostatectomy for PCa were included retrospectively. Four readers independently assigned a Likert score (ranging from 1 to 5) for predicting extra-prostatic extension (EPE) on T2W + DWI (bpMRI) and then on T2W + DWI + DCE imaging (mpMRI). MRI-based staging results were compared with radical prostatectomy histology. A prediction of EPE generalized linear mixed model was used to assess the added-value of DCE and discriminative power of staging accuracy by area under the receiver-operating curve (AUC ROC)., Results: AUC was not significantly improved by DCE (mpMRI, AUC = 0.73 [95%CI: 0.655‒0.827] vs. bpMRI, AUC = 0.76 [95%CI: 0.681‒0.846]). After applying a selection procedure, only MRI criteria were retained in a multivariate model. The following criteria were significantly associated with local extension: localization in the peripheral zone (p < 0.001), maximal diameter of the lesion (<0.0001), curvilinear capsular contact on T2W (p < 0.0001), capsular irregularity on T2W (p < 0.0001), bulging on T2W (p < 0.001) and seminal vesicle hypo-signal (p < 0.001)., Conclusion: Use of bpMRI did not result in a decrease in local staging accuracy., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2020
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21. MRI for prostate cancer: can computed high b-value DWI replace native acquisitions?
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Jendoubi S, Wagner M, Montagne S, Ezziane M, Mespoulet J, Comperat E, Estellat C, Baptiste A, and Renard-Penna R
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- Aged, Biopsy, Humans, Image Enhancement, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Magnetic Resonance Imaging methods, Neoplasm Staging methods, Prostate pathology, Prostatic Neoplasms diagnosis
- Abstract
Objective: To compare computed high b-value diffusion-weighted images (c-DWI) derived from low b-value DWI images and acquired high b-value DWI (a-DWI), in overall image quality and prostate cancer detection rate., Materials and Methods: A total of 124 consecutive men with suspected prostate cancer (PCa) underwent diagnosis prostate MRI on a 3.0 T MR system using a 32-channel phased-array torso coil. Among them, 63 underwent prostate biopsy. MRI protocol included 3DT2w images, high resolution Fov Optimized and Constrained Undistorted Single-Shot (FOCUS™) DWI images with b-values of 100, 400, 800, and 2000 s/mm
2 and dynamic contrast enhanced images. C-DWI images (2000 and 2500 s/mm2 ) were derived from the three lower acquired b-value DWI images using a mono-exponential diffusion decay. C-DWI and acquired high b-value DWI (a-DWI) (2000 s/mm2 ) were compared for image quality (background signal suppression, anatomic clarity, ghosting, distortion) and tumor conspicuity by four radiologists., Results: C-DWIs demonstrated higher rating than a-DWIs for overall image quality despite worsened ghosting. In patients with a biopsy, similar detection rate was observed while conspicuity was better with c-DWI (p < 0.001). Non-acquisition of high b-value a-DWI reduced total acquisition time by 220 s per patient., Conclusion: C-DWI provides a substantial reduction in acquisition time while maintaining comparable prostate cancer detection rate and improving global image quality., Key Points: • Computed DWI improves global quality of prostate MRI. • Computed DWI improves analysis of DWI images with decrease acquisition time. • Computed DWI provides greater background suppression of parenchyma and improves conspicuity of suspicious lesion.- Published
- 2019
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22. Kidney cortex segmentation in 2D CT with U-Nets ensemble aggregation.
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Couteaux V, Si-Mohamed S, Renard-Penna R, Nempont O, Lefevre T, Popoff A, Pizaine G, Villain N, Bloch I, Behr J, Bellin MF, Roy C, Rouvière O, Montagne S, Lassau N, and Boussel L
- Subjects
- Algorithms, Datasets as Topic, Humans, Artificial Intelligence, Kidney Cortex diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Purpose: This work presents our contribution to one of the data challenges organized by the French Radiology Society during the Journées Francophones de Radiologie. This challenge consisted in segmenting the kidney cortex from coronal computed tomography (CT) images, cropped around the cortex., Materials and Methods: We chose to train an ensemble of fully-convolutional networks and to aggregate their prediction at test time to perform the segmentation. An image database was made available in 3 batches. A first training batch of 250 images with segmentation masks was provided by the challenge organizers one month before the conference. An additional training batch of 247 pairs was shared when the conference began. Participants were ranked using a Dice score., Results: The segmentation results of our algorithm match the renal cortex with a good precision. Our strategy yielded a Dice score of 0.867, ranking us first in the data challenge., Conclusion: The proposed solution provides robust and accurate automatic segmentations of the renal cortex in CT images although the precision of the provided reference segmentations seemed to set a low upper bound on the numerical performance. However, this process should be applied in 3D to quantify the renal cortex volume, which would require a marked labelling effort to train the networks., (Copyright © 2019 Soci showét showé françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2019
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23. Five simultaneous artificial intelligence data challenges on ultrasound, CT, and MRI.
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Lassau N, Estienne T, de Vomecourt P, Azoulay M, Cagnol J, Garcia G, Majer M, Jehanno E, Renard-Penna R, Balleyguier C, Bidault F, Caramella C, Jacques T, Dubrulle F, Behr J, Poussange N, Bocquet J, Montagne S, Cornelis F, Faruch M, Bresson B, Brunelle S, Jalaguier-Coudray A, Amoretti N, Blum A, Paisant A, Herreros V, Rouviere O, Si-Mohamed S, Di Marco L, Hauger O, Garetier M, Pigneur F, Bergère A, Cyteval C, Fournier L, Malhaire C, Drape JL, Poncelet E, Bordonne C, Cauliez H, Budzik JF, Boisserie M, Willaume T, Molière S, Peyron Faure N, Caius Giurca S, Juhan V, Caramella T, Perrey A, Desmots F, Faivre-Pierre M, Abitbol M, Lotte R, Istrati D, Guenoun D, Luciani A, Zins M, Meder JF, and Cotten A
- Subjects
- Breast Neoplasms diagnostic imaging, Communication, Computer Security, Humans, Interprofessional Relations, Kidney Cortex diagnostic imaging, Liver Neoplasms diagnostic imaging, Magnetic Resonance Imaging, Neoplasm Invasiveness diagnostic imaging, Thyroid Cartilage diagnostic imaging, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms pathology, Tibial Meniscus Injuries diagnostic imaging, Tomography, X-Ray Computed, Ultrasonography, Artificial Intelligence, Datasets as Topic
- Abstract
Purpose: The goal of this data challenge was to create a structured dynamic with the following objectives: (1) teach radiologists the new rules of General Data Protection Regulation (GDPR), while building a large multicentric prospective database of ultrasound, computed tomography (CT) and MRI patient images; (2) build a network including radiologists, researchers, start-ups, large companies, and students from engineering schools, and; (3) provide all French stakeholders working together during 5 data challenges with a secured framework, offering a realistic picture of the benefits and concerns in October 2018., Materials and Methods: Relevant clinical questions were chosen by the Société Francaise de Radiologie. The challenge was designed to respect all French ethical and data protection constraints. Multidisciplinary teams with at least one radiologist, one engineering student, and a company and/or research lab were gathered using different networks, and clinical databases were created accordingly., Results: Five challenges were launched: detection of meniscal tears on MRI, segmentation of renal cortex on CT, detection and characterization of liver lesions on ultrasound, detection of breast lesions on MRI, and characterization of thyroid cartilage lesions on CT. A total of 5,170 images within 4 months were provided for the challenge by 46 radiology services. Twenty-six multidisciplinary teams with 181 contestants worked for one month on the challenges. Three challenges, meniscal tears, renal cortex, and liver lesions, resulted in an accuracy>90%. The fourth challenge (breast) reached 82% and the lastone (thyroid) 70%., Conclusion: Theses five challenges were able to gather a large community of radiologists, engineers, researchers, and companies in a very short period of time. The accurate results of three of the five modalities suggest that artificial intelligence is a promising tool in these radiology modalities., (Copyright © 2019 Soci showét showé françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2019
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24. The influence of students' prior clinical skills and context characteristics on mini-CEX scores in clerkships--a multilevel analysis.
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Rogausch A, Beyeler C, Montagne S, Jucker-Kupper P, Berendonk C, Huwendiek S, Gemperli A, and Himmel W
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- Clinical Clerkship methods, Education, Medical, Undergraduate methods, Educational Measurement methods, Humans, Multilevel Analysis, Students, Medical, Switzerland, Clinical Clerkship standards, Clinical Competence standards, Education, Medical, Undergraduate standards, Educational Measurement standards
- Abstract
Background: In contrast to objective structured clinical examinations (OSCEs), mini-clinical evaluation exercises (mini-CEXs) take place at the clinical workplace. As both mini-CEXs and OSCEs assess clinical skills, but within different contexts, this study aims at analyzing to which degree students' mini-CEX scores can be predicted by their recent OSCE scores and/or context characteristics., Methods: Medical students participated in an end of Year 3 OSCE and in 11 mini-CEXs during 5 different clerkships of Year 4. The students' mean scores of 9 clinical skills OSCE stations and mean 'overall' and 'domain' mini-CEX scores, averaged over all mini-CEXs of each student were computed. Linear regression analyses including random effects were used to predict mini-CEX scores by OSCE performance and characteristics of clinics, trainers, students and assessments., Results: A total of 512 trainers in 45 clinics provided 1783 mini-CEX ratings for 165 students; OSCE results were available for 144 students (87%). Most influential for the prediction of 'overall' mini-CEX scores was the trainers' clinical position with a regression coefficient of 0.55 (95%-CI: 0.26-0.84; p < .001) for residents compared to heads of department. Highly complex tasks and assessments taking place in large clinics significantly enhanced 'overall' mini-CEX scores, too. In contrast, high OSCE performance did not significantly increase 'overall' mini-CEX scores., Conclusion: In our study, Mini-CEX scores depended rather on context characteristics than on students' clinical skills as demonstrated in an OSCE. Ways are discussed which focus on either to enhance the scores' validity or to use narrative comments only.
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- 2015
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25. Losing connectivity when using EHRs: a technological or an educational problem?
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Nouns Z, Montagne S, and Huwendiek S
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- Humans, Data Collection methods, Electronic Health Records, Interprofessional Relations, Patient Care Team
- Published
- 2015
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26. Neuroinflammation and Aβ accumulation linked to systemic inflammation are decreased by genetic PKR down-regulation.
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Carret-Rebillat AS, Pace C, Gourmaud S, Ravasi L, Montagne-Stora S, Longueville S, Tible M, Sudol E, Chang RC, Paquet C, Mouton-Liger F, and Hugon J
- Subjects
- Amyloid Precursor Protein Secretases genetics, Amyloid Precursor Protein Secretases metabolism, Animals, Aspartic Acid Endopeptidases genetics, Aspartic Acid Endopeptidases metabolism, Brain metabolism, Brain pathology, Cytokines biosynthesis, Disease Models, Animal, Down-Regulation, Enzyme Activation, Hippocampus metabolism, Hippocampus pathology, Inflammation diagnosis, Inflammation pathology, Lipopolysaccharides administration & dosage, Lipopolysaccharides adverse effects, Magnetic Resonance Imaging, Mice, Mice, Knockout, Microglia immunology, Microglia metabolism, Phosphorylation, Positron-Emission Tomography, STAT3 Transcription Factor metabolism, eIF-2 Kinase antagonists & inhibitors, eIF-2 Kinase metabolism, Amyloid beta-Peptides metabolism, Gene Expression Regulation, Inflammation genetics, Inflammation metabolism, eIF-2 Kinase genetics
- Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder, marked by senile plaques composed of amyloid-β (Aβ) peptide, neurofibrillary tangles, neuronal loss and neuroinflammation. Previous works have suggested that systemic inflammation could contribute to neuroinflammation and enhanced Aβ cerebral concentrations. The molecular pathways leading to these events are not fully understood. PKR is a pro-apoptotic kinase that can trigger inflammation and accumulates in the brain and cerebrospinal fluid of AD patients. The goal of the present study was to assess if LPS-induced neuroinflammation and Aβ production could be altered by genetic PKR down regulation. The results show that, in the hippocampus of LPS-injected wild type mice, neuroinflammation, cytokine release and Aβ production are significantly increased and not in LPS-treated PKR knock-out mice. In addition BACE1 and activated STAT3 levels, a putative transcriptional regulator of BACE1, were not found increased in the brain of PKR knock-out mice as observed in wild type mice. Using PET imaging, the decrease of hippocampal metabolism induced by systemic LPS was not observed in LPS-treated PKR knock-out mice. Altogether, these findings demonstrate that PKR plays a major role in brain changes induced by LPS and could be a valid target to modulate neuroinflammation and Aβ production.
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- 2015
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27. The mini-clinical evaluation exercise during medical clerkships: are learning needs and learning goals aligned?
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Montagne S, Rogausch A, Gemperli A, Berendonk C, Jucker-Kupper P, and Beyeler C
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- Adult, Female, Humans, Learning, Male, Organizational Objectives, Retrospective Studies, Switzerland, Young Adult, Clinical Clerkship organization & administration, Clinical Competence, Education, Medical organization & administration, Educational Measurement methods, Goals, Needs Assessment organization & administration
- Abstract
Objectives: The generation of learning goals (LGs) that are aligned with learning needs (LNs) is one of the main purposes of formative workplace-based assessment. In this study, we aimed to analyse how often trainer-student pairs identified corresponding LNs in mini-clinical evaluation exercise (mini-CEX) encounters and to what degree these LNs aligned with recorded LGs, taking into account the social environment (e.g. clinic size) in which the mini-CEX was conducted., Methods: Retrospective analyses of adapted mini-CEX forms (trainers' and students' assessments) completed by all Year 4 medical students during clerkships were performed. Learning needs were defined by the lowest score(s) assigned to one or more of the mini-CEX domains. Learning goals were categorised qualitatively according to their correspondence with the six mini-CEX domains (e.g. history taking, professionalism). Following descriptive analyses of LNs and LGs, multi-level logistic regression models were used to predict LGs by identified LNs and social context variables., Results: A total of 512 trainers and 165 students conducted 1783 mini-CEXs (98% completion rate). Concordantly, trainer-student pairs most often identified LNs in the domains of 'clinical reasoning' (23% of 1167 complete forms), 'organisation/efficiency' (20%) and 'physical examination' (20%). At least one 'defined' LG was noted on 313 student forms (18% of 1710). Of the 446 LGs noted in total, the most frequently noted were 'physical examination' (49%) and 'history taking' (21%). Corresponding LNs as well as social context factors (e.g. clinic size) were found to be predictors of these LGs., Conclusions: Although trainer-student pairs often agreed in the LNs they identified, many assessments did not result in aligned LGs. The sparseness of LGs, their dependency on social context and their partial non-alignment with students' LNs raise questions about how the full potential of the mini-CEX as not only a 'diagnostic' but also an 'educational' tool can be exploited., (© 2014 John Wiley & Sons Ltd.)
- Published
- 2014
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28. [Is carotid resection a valuable option in advanced head and neck squamous cell carcinomas].
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Verhaeghe JL, Montagne S, Belotzerkovski I, Bracard S, Henneton C, Lapeyre M, Meistelman C, and Dolivet G
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- Brain Ischemia diagnosis, Carcinoma, Squamous Cell pathology, Carotid Artery Diseases pathology, Carotid Artery, External pathology, Carotid Artery, External surgery, Carotid Artery, Internal pathology, Carotid Artery, Internal surgery, Head and Neck Neoplasms pathology, Humans, Neoplasm Invasiveness, Patient Selection, Venous Pressure, Brain Ischemia complications, Carcinoma, Squamous Cell surgery, Carotid Artery Diseases surgery, Head and Neck Neoplasms surgery
- Abstract
Head and neck squamous cell carcinomas may involve the carotid artery. Surgical treatment of these tumors is a difficult challenge, because of related morbidity and mortality. The aim of this study of international literature was to define the best preoperative and intraoperative strategy which permits carotid resection with acceptable neurologic risk. Pre-operative evaluation of cerebral tolerance to carotid occlusion is performed. If the patient has successfully completed the 30-minute temporary occlusion of the internal carotid artery, a permanent balloon occlusion is performed. Surgical treatment includes carotid resection with or without revascularization using an autogenous graft. Elective carotid resection without reconstruction results in cerebral complications in 0 to 25% of patients, and death in 0 to 30% of patients. If a reconstruction using a graft is performed, cerebral complications occur in 0 to 22% of patients, and death in 0 to 33% of patients. Anastomotic rupture occurs in 0 to 33% of patients. However, many authors reported no neurologic complications and no deaths after performing successful preoperative permanent balloon occlusion of the internal carotid associated with carotid resection. Carotid resection can be performed with an acceptable cerebral risk in selected patients. Preoperative carotid occlusion seems to result in decreased postoperative mortality and morbidity rates. Prospective studies should be done to clarify the benefit of this procedure., (Copyright John Libbey Eurotext 2003.)
- Published
- 2003
29. [How to prevent surgical morbidity after a total thyroidectomy for a multinodular euthyroid goiter?].
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Montagne S, Brunaud L, Bresler L, Ayav A, Tortuyaux JM, and Boissel P
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- Adult, Aged, Female, Humans, Hypocalcemia etiology, Hypocalcemia prevention & control, Male, Middle Aged, Morbidity, Retrospective Studies, Thyroidectomy methods, Treatment Outcome, Vocal Cord Paralysis etiology, Vocal Cord Paralysis prevention & control, Goiter, Nodular surgery, Thyroidectomy adverse effects
- Abstract
Aim of the Study: Total thyroidectomy has been advocated for the treatment of multinodular nontoxic and benign goiter. The aim of this study, based on our experience, was to define the surgical factors which permit to decrease morbidity related to total thyroidectomy for multinodular euthyroid benign goiter., Methods and Materials: In a retrospective study performed between January 1996 and September 2000, all records of total thyroidectomy for initial treatment of multinodular euthyroid benign goiter were reviewed. This study allowed to specify recurrent and parathyroid morbidity after surgery., Results: There were 51 women and 13 men with a mean age of 47 years. Recurrent laryngeal nerve injury occurred in 2 patients. It resolved in 1 patient but was permanent in another (1.6%). Transient hypocalcemia was found in 8 patients (12.5%). One patient had permanent hypocalcemia (1.6%)., Conclusion: The results of our serie are comparable to previous reports. Systematic identification of the recurrent laryngeal nerve, and preservation of the parathyroid blood supply permit to decrease the surgical morbidity.
- Published
- 2002
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