Functional neuroanatomy underlying the clinical subcategorization of minimally conscious state patients.
Bruno, Marie-Aurélie ; Majerus, Steve ; Boly, Mélanie et al
in Journal of Neurology (2012), 259(6), 1087-98
Patients in a minimally conscious state (MCS) show restricted signs of awareness but are unable to communicate. We assessed cerebral glucose metabolism in MCS patients and tested the hypothesis that this ... [more ▼]
Patients in a minimally conscious state (MCS) show restricted signs of awareness but are unable to communicate. We assessed cerebral glucose metabolism in MCS patients and tested the hypothesis that this entity can be subcategorized into MCS- (i.e., patients only showing nonreflex behavior such as visual pursuit, localization of noxious stimulation and/or contingent behavior) and MCS+ (i.e., patients showing command following).Patterns of cerebral glucose metabolism were studied using [(18)F]-fluorodeoxyglucose-PET in 39 healthy volunteers (aged 46 +/- 18 years) and 27 MCS patients of whom 13 were MCS- (aged 49 +/- 19 years; 4 traumatic; 21 +/- 23 months post injury) and 14 MCS+ (aged 43 +/- 19 years; 5 traumatic; 19 +/- 26 months post injury). Results were thresholded for significance at false discovery rate corrected p < 0.05.We observed a metabolic impairment in a bilateral subcortical (thalamus and caudate) and cortical (fronto-temporo-parietal) network in nontraumatic and traumatic MCS patients. Compared to MCS-, patients in MCS+ showed higher cerebral metabolism in left-sided cortical areas encompassing the language network, premotor, presupplementary motor, and sensorimotor cortices. A functional connectivity study showed that Broca's region was disconnected from the rest of the language network, mesiofrontal and cerebellar areas in MCS- as compared to MCS+ patients.The proposed subcategorization of MCS based on the presence or absence of command following showed a different functional neuroanatomy. MCS- is characterized by preserved right hemispheric cortical metabolism interpreted as evidence of residual sensory consciousness. MCS+ patients showed preserved metabolism and functional connectivity in language networks arguably reflecting some additional higher order or extended consciousness albeit devoid of clinical verbal or nonverbal expression. [less ▲]Detailed reference viewed: 262 (10 ULg)
Tumor-induced osteomalacia: The tumor may stay hidden!
; CAVALIER, Etienne ; KAUX, Jean-François et al
in Clinical Biochemistry (2011), 44(14-15), 1264-6
We report the case of a patient with severe muscular and articular tenderness that caused almost complete immobility. This subject had severe hypophosphatemia due to hyperphosphaturia. Fibroblast growth ... [more ▼]
We report the case of a patient with severe muscular and articular tenderness that caused almost complete immobility. This subject had severe hypophosphatemia due to hyperphosphaturia. Fibroblast growth factor 23 (FGF-23) was abnormally high and the diagnostic of tumor-induced osteomalacia was made. Despite multiple tests, the tumor was not localized. In this report, we discuss different possible investigations to localize the tumor. Lastly, we review the potential therapy available when tumor is not found and can thus not be excised. [less ▲]Detailed reference viewed: 56 (17 ULg)
Hypophosphatémie et ostéomalacie oncogénique
; CAVALIER, Etienne ; COLSON, Laurent et al
in Revue Médicale Suisse (2011), 7
In this article, we will discuss about hypophosphatemia due to tumor-induced osteomalacia. This disease is characterized by severe muscular and articular tenderness inducing profound walking limitation ... [more ▼]
In this article, we will discuss about hypophosphatemia due to tumor-induced osteomalacia. This disease is characterized by severe muscular and articular tenderness inducing profound walking limitation. Clinical chemistry results show severe hypophosphatemia due to hyperphosphaturia. Fibroblast growth factor 23 (FGG-23) is abnormally high. Physiological role of FGF-23 is examined. We also consider the pathophysiology of tumor induced osteomalacia, the use of different investigations to localize the tumor and therapies available to treat this rare disease. [less ▲]Detailed reference viewed: 127 (9 ULg)
Potentialités quantitatives et qualité d'image de la camera TEMP/TDM Siemens Symbia T6
Seret, Alain ; Nguyen, Daniel ; HUSTINX, Roland et al
in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (2011, May 07), 35Detailed reference viewed: 55 (32 ULg)
Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study
MAGIS, Delphine ; Bruno, Marie-Aurélie ; FUMAL, Arnaud et al
in BMC Neurology (2011), 11Detailed reference viewed: 32 (10 ULg)
Reduced grey matter metabolism due to white matter edema allows optimal assessment of brain tumors on 18F-FDG-PET.
; ; et al
in Hellenic journal of nuclear medicine (2011), 14(3), 219-23
The main aim of this research was to demonstrate that the cortical and subcortical grey matter hypometabolism as revealed by fluorine-18 fluorodesoxyglucose-positron emission tomography ((18)F-FDG-PET ... [more ▼]
The main aim of this research was to demonstrate that the cortical and subcortical grey matter hypometabolism as revealed by fluorine-18 fluorodesoxyglucose-positron emission tomography ((18)F-FDG-PET) imaging in brain tumors is related to associated edema as demonstrated by magnetic resonance imaging (MRI). This in turn enhances the ability to assess disease activity in the tumor and the degree of loss of cerebral function in the adjacent and distant structures. We evaluated brain T1 and T2 weighted MRI and (18)F-FDG-PET scans of 29 patients (19 adult, 10 pediatric) with history of brain tumor. Tumor histology types included 21 gliomas, 1 melanoma, 1 primitive neuroectodermal tumor, 3 medulloblastomas and 3 ependymomas. The majority of scans were performed within the same week (94% <1 month. The extent of hypo and hypermetabolism was assessed on the (18)F-FDG-PET scans. A template of 12 regions of interest (ROI) was applied and the laterality indices of the regional counts (signal intensity) were computed. Extent of edema, enhancement, and anatomical change were assessed on the MRI scans. Extent of edema in the same ROI was evaluated by a 6-point semiquantitative scale and laterality indices were generated. Metabolic activity of the grey matter was correlated with the extent of edema using these indices. In all cases where edema was present, significant hypometabolism was observed in the adjacent structures. Overall, there was a strong correlation between the extent of edema and severity of hypometabolism (r=0.92, P=0.01). This was true regardless of the location of edema, whether there was history of radiation treatment (r=0.91, P=0.03), or not (r=0.97, P=0.17). In conclusion, edema independent of underlying variables appeared to contribute significantly to cortical and sub-cortical grey matter hypometabolism observed in patients with brain tumors. This would indicate that brain tumors can be successfully assessed by (18)F-FDG-PET and therefore the efforts for utilizing other tracers may not be justified. [less ▲]Detailed reference viewed: 18 (0 ULg)
2-18F-Fluoro-L-tyrosine in the suspicion of recurrence of previously treated gliomas.
; NAMUR, Gauthier ; et al
in European Journal of Nuclear Medicine and Molecular Imaging (2011), 38(SUPPL), 219Detailed reference viewed: 20 (1 ULg)
Assessment of Crohn’s disease activity by FDG-PET/CT through a novel quantitative approach.
; HUSTINX, Roland ; et al
in Journal of Nuclear Medicine (The) (2011), 52(SUPPL), 284Detailed reference viewed: 6 (0 ULg)
Evaluation of the homing process in the treatment of atrophic nonunion fractures by percutaneous autologous osteoblast cell implantation.
; HAUZEUR, Jean-Philippe ; LECHANTEUR, Chantal et al
in Journal of Nuclear Medicine (The) (2011), 52(SUPPL), 510Detailed reference viewed: 20 (0 ULg)
Efficacy of FDG PET/CT for diagnosing synchronous tumors and metastases in head and neck tumors : Initial results and evaluation.
; DEMEZ, Pierre ; MOREAU, Pierre et al
in Journal of Nuclear Medicine (The) (2011), 52(SUPPL), 1863Detailed reference viewed: 46 (14 ULg)
Hétérogénéité des métastases osseuses du cancer du sein : cas clinique illustrant l'intérêt de combiner différentes techniques d'imagerie
WITHOFS, Nadia ; COLLIGNON, Joëlle ; RORIVE, Andrée et al
in Revue Médicale de Liège (2011), 66(5-6), 288-290Detailed reference viewed: 74 (11 ULg)
Imagerie des métastases osseuses du cancer du sein
WITHOFS, Nadia ; COLLIGNON, Joëlle ; HUSTINX, Roland
in Revue Médicale de Liège (2011), 66(5-6), 291-298Detailed reference viewed: 71 (8 ULg)
FDG PET/CT for radiotherapy treatment planning. Comparison of functional volume delineation algorithms
WITHOFS, Nadia ; Bernard, Claire ; VAN DER REST, Catherine et al
in Journal of nuclear medicine (2011)Detailed reference viewed: 37 (16 ULg)
"Relevance vector machine" consciousness classifier applied to cerebral metabolism of vegetative and locked-in patients.
Phillips, Christophe ; Bruno, Marie-Aurélie ; Maquet, Pierre et al
in NeuroImage (2011), 56(2), 797808
The vegetative state is a devastating condition where patients awaken from their coma (i.e., open their eyes) but fail to show any behavioural sign of conscious awareness. Locked-in syndrome patients also ... [more ▼]
The vegetative state is a devastating condition where patients awaken from their coma (i.e., open their eyes) but fail to show any behavioural sign of conscious awareness. Locked-in syndrome patients also awaken from their coma and are unable to show any motor response to command (except for small eye movements or blinks) but recover full conscious awareness of self and environment. Bedside evaluation of residual cognitive function in coma survivors often is difficult because motor responses may be very limited or inconsistent. We here aimed to disentangle vegetative from "locked-in" patients by an automatic procedure based on machine learning using fluorodeoxyglucose PET data obtained in 37 healthy controls and in 13 patients in a vegetative state. Next, the trained machine was tested on brain scans obtained in 8 patients with locked-in syndrome. We used a sparse probabilistic Bayesian learning framework called "relevance vector machine" (RVM) to classify the scans. The trained RVM classifier, applied on an input scan, returns a probability value (p-value) of being in one class or the other, here being "conscious" or not. Training on the control and vegetative state groups was assessed with a leave-one-out cross-validation procedure, leading to 100% classification accuracy. When applied on the locked-in patients, all scans were classified as "conscious" with a mean p-value of .95 (min .85). In conclusion, even with this relatively limited data set, we could train a classifier distinguishing between normal consciousness (i.e., wakeful conscious awareness) and the vegetative state (i.e., wakeful unawareness). Cross-validation also indicated that the clinical classification and the one predicted by the automatic RVM classifier were in accordance. Moreover, when applied on a third group of "locked-in" consciously aware patients, they all had a strong probability of being similar to the normal controls, as expected. Therefore, RVM classification of cerebral metabolic images obtained in coma survivors could become a useful tool for the automated PET-based diagnosis of altered states of consciousness. [less ▲]Detailed reference viewed: 92 (15 ULg)
18F-fluoride PET/CT for assessing bone involvement in prostate and breast cancers
Withofs, Nadia ; Grayet, Benjamin ; Tancredi, Tino et al
in Nuclear Medicine Communications (2011), 32(3), 168-176Detailed reference viewed: 73 (29 ULg)
Uptake of 18-FDG as detected by positron emission tomography is correlated to an increased inflammatory infiltrate and expression of proteolytic enzymes in abdominal aortic aneurysm wall
COURTOIS, Audrey ; Nusgens, Betty ; Defraigne, Jean-Olivier et al
Poster (2011)Detailed reference viewed: 18 (7 ULg)
Ganglion sentinelle et sentibras: pour un "staging" axillaire sur mesure
; BLERET, Valerie ; et al
in Revue Médicale de Liège (2011), 66(5-6), 336-40
The status of the axillary lymph nodes is one of the most important prognostic factors in women with early stage breast cancer. Histologic examination of removed lymph nodes is the most accurate method ... [more ▼]
The status of the axillary lymph nodes is one of the most important prognostic factors in women with early stage breast cancer. Histologic examination of removed lymph nodes is the most accurate method for assessing spread of disease to these nodes. Axillary lymph node dissection (ALND) remains the standard approach for women who have clinically palpable axillary nodes. The benefits of ALND include its impact on disease control (axillary recurrence and survival), its prognostic value, and its role in treatment selection. However, the anatomic disruption caused by ALND may result in lymphedema, nerve injury, and shoulder dysfunction, which compromise functionality and quality of life. For patients who have clinically negative axillary lymph nodes, sentinel lymph node (SLN) biopsy offers a less morbid method to determine if there are positive nodes, in which case axillary node dissection would be necessary. Patients who are SLN-positive should undergo complete ALND. Axillary reverse mapping (ARM) is a recent improvement of ALND which, like the biopsy of the GS, would reduce morbidity. [less ▲]Detailed reference viewed: 174 (9 ULg)
Multimodality staging of lung cancer
; NAMUR, Gauthier ; HUSTINX, Roland et al
in PET Clinics (2011), 6
Lung cancer is among the most common and lethal cancers around the world. Most lung cancers are directly attributed to smoking. Common histologic subtypes of lung carcinomas are squamous cell carcinoma ... [more ▼]
Lung cancer is among the most common and lethal cancers around the world. Most lung cancers are directly attributed to smoking. Common histologic subtypes of lung carcinomas are squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. These carcinomas have similar presentations and are primarily treated surgically. Hence, these are usually classified as non-small cell lung carcinoma. Small cell lung carcinoma is an aggressive neuroendocrine tumor with a generally poor prognosis. It usually presents with massive mediastinal lymphadenopathy and widespread metastases at initial diagnosis, and is usually treated with chemotherapy and radiotherapy; surgery has little role.Cough, dyspnea and hemoptysis are the consistent clinical features of most lung cancers. Advances tumors with pleural, chest wall, or mediastinal invasion produce a variety of additional clinical features such as chest pain, brachial plexus neuropathy, Horner syndrome, phrenic or recurrent laryngeal nerve palsy, dysphagia, or superior vena cava syndrome. Sone of the lung cancers are detected as small pulmonary nodules in asymptomatic individuals. [less ▲]Detailed reference viewed: 47 (11 ULg)
Fully Automated Preparation and Conjugation of N-Succinimidyl 4-[(18)F]Fluorobenzoate ([ (18)F]SFB) with RGD Peptide Using a GE FASTlab Synthesizer.
Thonon, David ; ; Goukens, Eve et al
in Molecular imaging and biology : MIB : the official publication of the Academy of Molecular Imaging (2011)
PURPOSE: The aim of this work was to automate the radiosynthesis of [(18)F]SFB, a widely used reagent for the labeling of biomolecules with (18)F on a new generation commercial synthesis module (FASTLab ... [more ▼]
PURPOSE: The aim of this work was to automate the radiosynthesis of [(18)F]SFB, a widely used reagent for the labeling of biomolecules with (18)F on a new generation commercial synthesis module (FASTLab, GE Healthcare). PROCEDURES: Two synthesis approaches were implemented on this module: the classical "two-pot radiosynthesis" and the more recently described "one-pot" method. RESULTS: The "two-pot" approach affords [(18)F]SFB with a 42% decay-corrected yield in 57 min (n = 24) with a chemical purity sufficient to avoid an intermediate HPLC purification. The recently established "one-pot" method, afforded a product with a lower chemical purity, in the conditions used in this report. The lower d.c. yield obtained (32% (n = 15)) was related to the low (18)F labeling yields obtained in MeCN compared with DMSO. The subsequent conjugation step with a RGD (PRGD2) peptide was also successfully automated. CONCLUSIONS: The formulated [(18)F]FPRGD2 was obtained without any operator manipulation with a d.c. yield of 13% +/- 3% (n = 13) in 130 min, a radiochemical purity >98% and a specific activity of 140 +/- 40 TBq/mmol. [less ▲]Detailed reference viewed: 89 (34 ULg)
Assessment of consciousness with electrophysiological and neurological imaging techniques.
Bruno, Marie-Aurélie ; Gosseries, Olivia ; Ledoux, Didier et al
in Current Opinion in Critical Care (2011)
PURPOSE OF REVIEW: Brain MRI (diffusion tensor imaging and spectroscopy) and functional neuroimaging (PET, functional MRI, EEG and evoked potential studies) are changing our understanding of patients with ... [more ▼]
PURPOSE OF REVIEW: Brain MRI (diffusion tensor imaging and spectroscopy) and functional neuroimaging (PET, functional MRI, EEG and evoked potential studies) are changing our understanding of patients with disorders of consciousness encountered after coma such as the 'vegetative' or minimally conscious states. RECENT FINDINGS: Increasing evidence from functional neuroimaging and electrophysiology demonstrates some residual cognitive processing in a subgroup of patients who clinically fail to show any response to commands, leading to the recent proposal of 'unresponsive wakefulness syndrome' as an alternative name for patients previously coined 'vegetative' or 'apallic'. SUMMARY: Consciousness can be viewed as the emergent property of the collective behavior of widespread thalamocortical frontoparietal network connectivity. Data from physiological, pharmacological and pathological alterations of consciousness provide evidence in favor of this hypothesis. Increasing our understanding of the neural correlates of consciousness is helping clinicians to do a better job in terms of diagnosis, prognosis and finally treatment and drug development for these severely brain-damaged patients. The current challenge remains to continue translating this research from the bench to the bedside. Only well controlled large multicentric neuroimaging and electrophysiology studies will enable to identify which paraclinical diagnostic or prognostic test is necessary for our routine evidence-based assessment of individuals with disorders of consciousness. [less ▲]Detailed reference viewed: 158 (10 ULg)