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See detail18F-FDG PET Uptake Characterization Through Texture Analysis: Investigating the Complementary Nature of Heterogeneite and Functional Tumor Volume in a Multi-Cancer Site Patient Cohort
HATT, MAT; MAJDOUB, MOHAMED; VALLIERES, MARTIN et al

in Journal of Nuclear Medicine (The) (2015), 56(1), 38-44

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See detailA theranostic tool for Hepatocellular carcinoma: the Starch-Based Microparticles
Verger, Elise ULg; Cikankowitz, Annabelle; Bouvier, Antoine et al

Conference (2015)

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See detailGene Expression Study in Positron Emission Tomography–Positive Abdominal Aortic Aneurysms Identifies CCL18 as a Potential Biomarker for Rupture Risk
Courtois, Audrey ULg; Nusgens-Richelle, Betty ULg; HUSTINX, Roland ULg et al

in Molecular Medicine (2015)

Rupture of abdominal aortic aneurysm (AAA) is a cause of significant mortality and morbidity in ageing populations. Uptake of 18-fluorodeoxyglucose (FDG) detected by positron emission tomography (PET) is ... [more ▼]

Rupture of abdominal aortic aneurysm (AAA) is a cause of significant mortality and morbidity in ageing populations. Uptake of 18-fluorodeoxyglucose (FDG) detected by positron emission tomography (PET) is observed in the wall of 12% of AAA (A+), most of them being symptomatic. We previously showed that the metabolically active areas displayed adventitial inflammation, medial degeneration and molecular alterations prefacing wall rupture. The aim of this study was to identify new factors predictive of rupture.Transcriptomic analyses were performed in the media and adventitia layers from three types of samples: AAA without (A0) and with FDG uptake (A+), both at the positive spot (A+Pos) and at a paired distant negative site (A+Neg) of the same aneurysm. Follow-up studies included RT-PCR, immunohistochemical staining and ELISA. A large number of genes, including matrix metalloproteinases, collagens and cytokines as well as genes involved in osteochondral development, were differentially expressed in the A+Pos as compared to A+Neg. Moreover, a series of genes, notably CCL18, was differentially expressed both in the A+Neg and A+Pos as compared to the A0. A significant increase of CCL18 was also found at the protein level in the aortic wall and in peripheral blood of A+ patients as compared to A0.In conclusion, new factors, including CCL18, involved in the progression of AAA and, potentially, in their rupture were identified by a genome-wide analysis of PET-positive and negative human aortic tissue samples. Further work is needed to study their role in AAA destabilization and weakening. [less ▲]

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See detailClinical Response to tDCS Depends on Residual Brain Metabolism and Grey Matter Integrity in Patients With Minimally Conscious State.
Thibaut, Aurore ULg; Di Perri, Carol; Chatelle, Camille ULg et al

in Brain stimulation (2015), 8(6), 1116-23

BACKGROUND: Transcranial direct current stimulation (tDCS) was recently shown to promote recovery of voluntary signs of consciousness in some patients in minimally conscious state (MCS). However, it ... [more ▼]

BACKGROUND: Transcranial direct current stimulation (tDCS) was recently shown to promote recovery of voluntary signs of consciousness in some patients in minimally conscious state (MCS). However, it remains unclear why clinical improvement is only observed in a subgroup of patients. OBJECTIVES: In this retrospective study, we investigated the relationship between tDCS responsiveness and neuroimaging data from MCS patients. METHODS: Structural Magnetic Resonance Imaging (MRI), Fluorodeoxyglucose Positron emission tomography (FDG-PET) and clinical electroencephalography (EEG) were acquired in 21 sub-acute and chronic MCS patients (8 tDCS responders) who subsequently (<48 h) received left dorsolateral prefrontal (DLPF) tDCS in a double-blind randomized cross-over trial. The behavioral data have been published elsewhere (Thibaut et al., Neurology, 2014). RESULTS: Grey matter atrophy was observed in non-responders as compared with responders in the left DLPF cortex, the medial-prefrontal cortex, the cingulate cortex, the hippocampi, part of the rolandic regions, and the left thalamus. FDG-PET showed hypometabolism in non-responders as compared with responders in the left DLPF cortex, the medial-prefrontal cortex, the precuneus, and the thalamus. EEG did not show any difference between the two groups. CONCLUSION: Our findings suggest that the transient increase of signs of consciousness following left DLPF tDCS in patients in MCS require grey matter preservation and residual metabolic activity in cortical and subcortical brain areas known to be involved in attention and working memory. These results further underline the critical role of long-range cortico-thalamic connections in consciousness recovery, providing important information for guidelines on the use of tDCS in disorders of consciousness. [less ▲]

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See detailQuantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients.
Stender, Johan; Kupers, Ron; Rodell, Anders et al

in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism (2015), 35(1), 58-65

The differentiation of the vegetative or unresponsive wakefulness syndrome (VS/UWS) from the minimally conscious state (MCS) is an important clinical issue. The cerebral metabolic rate of glucose (CMRglc ... [more ▼]

The differentiation of the vegetative or unresponsive wakefulness syndrome (VS/UWS) from the minimally conscious state (MCS) is an important clinical issue. The cerebral metabolic rate of glucose (CMRglc) declines when consciousness is lost, and may reveal the residual cognitive function of these patients. However, no quantitative comparisons of cerebral glucose metabolism in VS/UWS and MCS have yet been reported. We calculated the regional and whole-brain CMRglc of 41 patients in the states of VS/UWS (n=14), MCS (n=21) or emergence from MCS (EMCS, n=6), and healthy volunteers (n=29). Global cortical CMRglc in VS/UWS and MCS averaged 42% and 55% of normal, respectively. Differences between VS/UWS and MCS were most pronounced in the frontoparietal cortex, at 42% and 60% of normal. In brainstem and thalamus, metabolism declined equally in the two conditions. In EMCS, metabolic rates were indistinguishable from those of MCS. Ordinal logistic regression predicted that patients are likely to emerge into MCS at CMRglc above 45% of normal. Receiver-operating characteristics showed that patients in MCS and VS/UWS can be differentiated with 82% accuracy, based on cortical metabolism. Together these results reveal a significant correlation between whole-brain energy metabolism and level of consciousness, suggesting that quantitative values of CMRglc reveal consciousness in severely brain-injured patients. [less ▲]

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See detail18F-FDG PET/CT in the Management of Aortitis.
Bruls, Samuel; Courtois, Audrey ULg; Nusgens-Richelle, Betty ULg et al

in Clinical nuclear medicine (2015)

BACKGROUND: Aortitis is a generic term defined as an inflammatory condition involving the aortic wall, of infectious or noninfectious origin. This inflammatory process may deteriorate the aortic wall ... [more ▼]

BACKGROUND: Aortitis is a generic term defined as an inflammatory condition involving the aortic wall, of infectious or noninfectious origin. This inflammatory process may deteriorate the aortic wall, resulting in potentially life-threatening vascular complications. Therefore, it is important to establish a diagnosis as early as possible. PATIENTS AND METHODS: During a 4-year period, 428 consecutive patients referred to our department for aortic diseases underwent FDG PET/CT examinations. Among these, 18 patients (4.2%) were suspected to have aortitis. All of them had an initial positive FDG PET/CT uptake occurring in the aorta and major branches as evaluated by visual analysis of images and assessed with the final diagnosis of aortitis. During follow-up, after surgery and/or upon immunosuppressive treatment, each of these patients underwent a second PET/CT that was compared with the initial evaluation. In all cases, normalization of FDG uptake was correlated with clinical improvement. CONCLUSIONS: Our study aimed to illustrate the potential clinical value of functional monitoring with PET/CT in the management of aortitis. FDG PET/CT constitutes a valuable imaging modality to establish an early diagnosis, monitor disease progression and treatment, and evaluate vascular complication and relapse. We highlight the importance of an early detection of inflammatory large-vessel pathology, which may represent a major threat. [less ▲]

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See detailReply to G. Keramida et al.
Barrington, Sally F.; Mikhaeel, N. George; Kostakoglu, Lale et al

in Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2015), 33(34), 4121-2

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See detail(18)F-FPRGD2 PET/CT imaging of musculoskeletal disorders.
WITHOFS, Nadia ULg; CHARLIER, Edith ULg; Simoni, Paolo et al

in Annals of nuclear medicine (2015), 29(10), 839-47

OBJECTIVE: This work reports on musculoskeletal uptake of (18)F-FPRGD2, targeting the integrin alphavbeta3, in patients who had undergone (18)F-FPRGD2 positron emission tomography combined with computed ... [more ▼]

OBJECTIVE: This work reports on musculoskeletal uptake of (18)F-FPRGD2, targeting the integrin alphavbeta3, in patients who had undergone (18)F-FPRGD2 positron emission tomography combined with computed tomography (PET/CT) for oncologic purposes. METHODS: Whole-body (18)F-FPRGD2 PET/CT images of 62 cancer patients were retrospectively reviewed to detect foci of musculoskeletal (18)F-FPRGD2 uptake. For 37 patients, a FDG PET/CT performed in clinical settings was available. In each joint with an abnormal uptake, the maximum standardized uptake value (SUVmax) was estimated. RESULTS: A total of 260 musculoskeletal foci of (18)F-FPRGD2 uptake were detected. Most common sites of uptake were joints and discs (n = 160; 61.5 %), entheses (osteotendinous and osteoligamentous junctions; n = 55; 21.2 %) and recent fractures (n = 18; 6.9 %). In addition, 27 (10.4 %) miscellaneous foci were detected. Out of the 146 lesions for which a FDG PET was available, 63 % showed both (18)F-FPRGD2 and FDG uptake, 33.6 % did not show FDG avidity and 3.4 % showed only FDG uptake. The uptake intensity of the 92 lesions positive with (18)F-FPRGD2 and FDG was similar with both radiopharmaceuticals, but the target-to-background (blood pool or muscle) ratios were significantly higher with (18)F-FPRGD2 than with FDG (p < 0.0001). CONCLUSION: The (18)F-FPRGD2 uptake in joints, spine degenerative diseases and tendons was highly prevalent in our population. Up to one-third of (18)F-FPRGD2 foci showed no FDG uptake suggesting that (18)F-FPRGD2 signal may not be related to inflammatory angiogenesis only. [less ▲]

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See detailReply to B. Bennani-Baiti et al, H.J.A. Adams et al, E. Laffon et al, and E.A. Hawkes et al.
Barrington, Sally F.; Mikhaeel, N. George; Kostakoglu, Lale et al

in Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2015), 33(10), 1221-3

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See detailPitfalls and Limitations of PET/CT in Brain Imaging.
Salmon, Eric ULg; Bernard, Claire ULg; HUSTINX, Roland ULg

in Seminars in nuclear medicine (2015), 45(6), 541-51

Neurologic applications were at the forefront of PET imaging when the technique was developed in the mid-1970s. Although oncologic indications have become prominent in terms of number of studies performed ... [more ▼]

Neurologic applications were at the forefront of PET imaging when the technique was developed in the mid-1970s. Although oncologic indications have become prominent in terms of number of studies performed worldwide, neurology remains a major field in which functional imaging provides unique information, both for clinical and research purposes. The evaluation of glucose metabolism using FDG remains the most frequent exploration, but in recent years, alternative radiotracers have been developed, including fluorinated amino acid analogues for primary brain tumor imaging and fluorinated compounds for assessing the amyloid deposits in patients with suspected Alzheimer disease. As the brain is enclosed in the skull, which presents fixed landmarks, it is relatively easy to coregister images obtained with various cross-sectional imaging methods, either functional or anatomical, with a relatively high accuracy and robustness. Nevertheless, PET in neurology has fully benefited from the advent of hybrid imaging. Attenuation and scatter correction is now much faster and equally accurate, using CT as compared with the traditional transmission scan using an external radioactive source. The perfect coregistration with the CT data, which is now systematically performed, also provides its own set of valuable information, for instance regarding cerebral atrophy. However, hybrid imaging in neurology comes with pitfalls and limitations, in addition to those that are well known, for example, blood glucose levels or psychotropic drugs that greatly affect the physiological FDG uptake. Movements of the patient's head, either during the PET acquisition or between the PET and the CT acquisitions will generate artifacts that may be very subtle yet lead to erroneous interpretation of the study. Similarly, quantitative analysis, such as voxel-based analyses, may prove very helpful in improving the diagnostic accuracy and the reproducibility of the reading, but a wide variety of artifacts may also be introduced, and should therefore be identified and corrected. [less ▲]

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See detailNuclear medicine training in the European Union : 2015 Update
PRIGENT, ALAIN; HUSTINX, Roland ULg; COSTA, DURVAL C.

in European Journal of Nuclear Medicine and Molecular Imaging (2015)

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See detailCirculating miRNA signature of PET-positive abdominal aortic aneurysms: new potential predictors of rupture
Courtois, Audrey ULg; Nusgens-Richelle, Betty ULg; HUSTINX, Roland ULg et al

in Atherosclerosis, Thrombosis and Vascular Biology (2015)

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See detailChanges in cerebral metabolism in patients with a minimally conscious state responding to zolpidem.
Chatelle, Camille ULg; Thibaut, Aurore ULg; Gosseries, Olivia ULg et al

in Frontiers in Neuroscience (2014)

BACKGROUND: Zolpidem, a short-acting non-benzodiazepine GABA agonist hypnotic, has been shown to induce paradoxical responses in some patients with disorders of consciousness (DOC), leading to recovery of ... [more ▼]

BACKGROUND: Zolpidem, a short-acting non-benzodiazepine GABA agonist hypnotic, has been shown to induce paradoxical responses in some patients with disorders of consciousness (DOC), leading to recovery of arousal and cognitive abilities. We here assessed zolpidem-induced changes in regional brain metabolism in three patients with known zolpidem response in chronic post-anoxic minimally conscious state (MCS). METHODS: [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) and standardized clinical assessments using the Coma Recovery Scale-Revised were performed after administration of 10 mg zolpidem or placebo in a randomized double blind 2-day protocol. PET data preprocessing and comparison with a healthy age-matched control group were performed using statistical parametric mapping (SPM8). RESULTS: Behaviorally, all patients recovered functional communication after administration of zolpidem (i.e., emergence from the MCS). FDG-PET showed increased metabolism in dorsolateral prefrontal and mesiofrontal cortices after zolpidem but not after placebo administration. CONCLUSION: Our data show a metabolic activation of prefrontal areas, corroborating the proposed mesocircuit hypothesis to explain the paradoxical effect of zolpidem observed in some patients with DOC. It also suggests the key role of the prefrontal cortices in the recovery of functional communication and object use in hypoxic patients with chronic MCS. [less ▲]

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See detailRadiolabelling of starch microparticles with Rhenium-188 for hepatocellular carcinoma’s therapy
Verger, Elise ULg; Bouvier, Antoine; Benoit, Jean-Pierre et al

in European Journal of Nuclear Medicine and Molecular Imaging (2014, October), 41(Supplement 2), 443-444

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See detailPrognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma.
MEURISSE, Nicolas ULg; DETRY, Olivier ULg; Govaerts, L et al

in Transplant International (2014, September), 27(S2), 18-17

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See detailRole of Imaging in the Staging and Response Assessment of Lymphoma : Consensus of the International Conference on Malignant Lymphomas Imaging Working Group
BARRINGTON, SALLY F.; MIKKHAEEL, N. GEORGE; KOSTAKOGLU, LALE et al

in Journal of Clinical Oncology (2014)

This article comprises the consensus reached to update guidance on the use of PET-CT for staging and response assessment for 18F FDG-avid lymphomas in clinical practice and late-phase trials.

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See detailOrthanc - Logiciel libre pour l'imagerie médicale en milieu hospitalier
JODOGNE, Sébastien ULg; LENAERTS, Eric ULg; COUCKE, Philippe ULg et al

in Communications de la Conférence Francophone en Gestion et Ingénierie des Systèmes Hospitaliers (GISEH 2014) (2014, July)

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See detailThe role of positron emission tomography-computed tomography and magnetic resonance imaging in diagnosis and follow-up of multiple myeloma
CAERS, Jo ULg; WITHOFS, Nadia ULg; Hillengass, Jens et al

in Haematologica (2014), 99(4), 629-37

Multiple myeloma is the second most common hematologic malignancy and occurs most commonly in elderly patients. Almost all multiple myeloma patients develop bone lesions in the course of their disease or ... [more ▼]

Multiple myeloma is the second most common hematologic malignancy and occurs most commonly in elderly patients. Almost all multiple myeloma patients develop bone lesions in the course of their disease or have evidence of bone loss at initial diagnosis. Whole-body conventional radiography remains the gold standard in the diagnostic evaluation, but computed tomography, magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography are increasingly used as complementary techniques in the detection of bone lesions. Moreover, the number of lesions detected and the presence of extramedullary disease give strong prognostic information. These new techniques may help to assess treatment response in solitary plasmacytoma or in multiple myeloma. In this article, we review recent data on the different imaging techniques used at diagnosis and in the assessment of treatment response, and discuss some current issues. [less ▲]

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See detailPrognostic value of FDG PET/CT in liver transplantation for hepatocarcinoma
DETRY, Olivier ULg; Govaerts, L; BLETARD, Noëlla ULg et al

in Acta Gastro-Enterologica Belgica (2014, March), 77(1), 08

AIM : FDG uptake has been shown to predict the outcome in large series of patients with hepatocarcinoma (HCC) in Asia, but few data are available regarding European populations. Our aim was to evaluate ... [more ▼]

AIM : FDG uptake has been shown to predict the outcome in large series of patients with hepatocarcinoma (HCC) in Asia, but few data are available regarding European populations. Our aim was to evaluate the prognostic value of pretreatment FDG PET-CT in patients treated by liver transplantation. Methods: We retrospectively analyzed the data of 27 patients (24 M and 3 W, mean age 58 ± 9 years). The mean follow-up was 26 ± 18 months (min 1 month, max 66 months). All patients had an FDG PET-CT before the transplantation. The FDG PET/CT was performed according to a standard clinical protocol: 4 MBqFDG/kg body weight, uptake 60 min., low-dose non-enhanced CT. We measured the SUVmax and SUVmean of the tumor and the normal liver. The tumor/liver activity ratios (RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors: MILAN, CLIP, OKUDA, TNM stage, alphafoetoprotein level, portal thrombosis, size of the largest nodule, tumor differentiation, microvascular invasion, underlying cirrhosis and liver function. Results : The DFS was 87.2% at 1y and 72.1% at 3y. The OS was 85.2% at 1y and 80.7% at 3y. According to an univariate Cox model, RSUVmax, RSUVmean and healthy liver were predictors of DFS and RSUVmax, RSUVmean, size of the largest nodule, CLIP, liver involvement>50%, and healthy liver predicted the OS. According to a multivariate Cox model, only RSUVmax predicted DFS and RSUVmax and liver involvement>50% predicted OS. An ROC analysis of the ratios showed that the 1.15 cut-off for RSUVmax was best for predicting both the DFS (Cox regression:HR 14.4, p=0.02) and OS (HR 5.6, p=0.049). The Kaplan-Meier curves and Logrank tests confirmed those results. Even though the MILAN criteria alone were not predictive, it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax<1.15 relapsed. Conclusions: The RSUVmax is a strong prognostic factor for recurrence and death in patients with HCC treated by liver transplantation with a cut-off value of 1,15. further prospective studies should test whether the metabolic index should be systematically included in the preoperative assessment. [less ▲]

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