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See detail"Relevance vector machine" consciousness classifier applied to cerebral metabolism of vegetative and locked-in patients.
Phillips, Christophe ULg; Bruno, Marie-Aurélie ULg; Maquet, Pierre ULg 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 ▲]

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See detail18F-fluoride PET/CT for assessing bone involvement in prostate and breast cancers
Withofs, Nadia ULg; Grayet, Benjamin ULg; Tancredi, Tino ULg et al

in Nuclear Medicine Communications (2011), 32(3), 168-176

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See detailGanglion sentinelle et sentibras: pour un "staging" axillaire sur mesure
Cusumano, P.; BLERET, Valerie ULg; Nos, C. 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 ▲]

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See detailMultimodality staging of lung cancer
THULKAR; NAMUR, Gauthier ULg; HUSTINX, Roland ULg 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 ▲]

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See detailFully Automated Preparation and Conjugation of N-Succinimidyl 4-[(18)F]Fluorobenzoate ([ (18)F]SFB) with RGD Peptide Using a GE FASTlab Synthesizer.
Thonon, David ULg; Goblet, D.; Goukens, Eve ULg 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 ▲]

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See detailAssessment of consciousness with electrophysiological and neurological imaging techniques.
Bruno, Marie-Aurélie ULg; Gosseries, Olivia ULg; Ledoux, Didier ULg 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 ▲]

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See detailVers une radiothérapie chirurgicale :nécessité d’une radiothérapie guidée par l’imagerie
COUCKE, Philippe ULg; WITHOFS, Nadia ULg; JANSEN, Nicolas ULg et al

in Revue Médicale de Liège (2010), 65(supp 1), 17-22

résumé : L’évolution extrêmement rapide en robotique et en informatique a permis l’avènement de techniques telles que le CcyberKnife®, capables d’appliquer en radiothérapie des doses dites «ablatives» et ... [more ▼]

résumé : L’évolution extrêmement rapide en robotique et en informatique a permis l’avènement de techniques telles que le CcyberKnife®, capables d’appliquer en radiothérapie des doses dites «ablatives» et ceci avec une précision chirurgicale. Ce type de traitement ablatif n’est pas réellement concevable avec des techniques conventionnelles en radiothérapie et des changements <br />majeurs de paradigmes ont eu lieu, particulièrement dans la méthodologie de définition de la cible et des marges ainsi que dans la manière dont on fractionne le traitement. Ggrâce à ces changements, on est à même de proposer aux patients des traitements <br />qui représentent un doublement au niveau de l’efficacité <br />biologique. Ppour obtenir une couverture optimale au niveau de la cible, tout en évitant les structures saines avoisinantes, il est donc impératif d’obtenir la meilleure définition possible de la cible tant au niveau de la l’extension de la lésion qu’au niveau de son «contenu», c’est-à-dire les caractéristiques métaboliques et fonctionnelles. Lla révolution technologique en cours dans le monde de l’imagerie métabolique et fonctionnelle va permettre d’utiliser l’information numérisée pour individualiser les traitements <br />et les adapter aux caractéristiques mêmes de la lésion ainsi qu’à son évolution au décours du traitement. [less ▲]

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See detailAssessment of early therapeutic response in anti-TNFα refractory rheumatoid arthritis with FDG PET/CT.
FOSSE, P.; KAISER, Marie-Joëlle ULg; NAMUR, Gauthier ULg et al

in European Journal of Nuclear Medicine and Molecular Imaging (2010), 37(SUPPL), 211

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See detailContribution of positron emission tomography in pleural disease.
Duysinx, Bernard ULg; Corhay, Jean-Louis ULg; Larock, Marie-Paule ULg et al

in Revue des Maladies Respiratoires (2010), 27(8), 47-53

INTRODUCTION: Positron emission tomography (PET) now plays a clear role in oncology, especially in chest tumours. We discuss the value of metabolic imaging in characterising pleural pathology in the light ... [more ▼]

INTRODUCTION: Positron emission tomography (PET) now plays a clear role in oncology, especially in chest tumours. We discuss the value of metabolic imaging in characterising pleural pathology in the light of our own experience and review the literature. BACKGROUND: PET is particularly useful in characterising malignant pleural pathologies and is a factor of prognosis in mesothelioma. Metabolic imaging also provides clinical information for staging lung cancer, in researching the primary tumour in metastatic pleurisy and in monitoring chronic or recurrent pleural pathologies. CONCLUSIONS: PET should therefore be considered as a useful tool in the diagnosis of liquid or solid pleural pathologies. [less ▲]

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See detailPET/CT in head and neck cancer: an update.
Hustinx, Roland ULg; Lucignani, Giovanni

in European Journal of Nuclear Medicine and Molecular Imaging (2010), 37(3), 645-51

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See detailChorea associated with anti-phospholipid antibodies: case report.
DEMONTY, Jean ULg; GONCE, Michel ULg; Ribai, P. et al

in Acta clinica Belgica (2010), 65(5), 350-3

A seventeen year-old boy developed left sided chorea in a few days, subsequently involving the four limbs. Although he presented a marfanoid phenotype, genetic analysis of the Fibrillin 1 was normal. The ... [more ▼]

A seventeen year-old boy developed left sided chorea in a few days, subsequently involving the four limbs. Although he presented a marfanoid phenotype, genetic analysis of the Fibrillin 1 was normal. The genes for familial chorea and Huntington's disease were also negative. Biological tests showed normal serum homocystein, but revealed very high levels of anti-beta2-GP1 IgG, anticardiolipin and lupus anticoagulant, which remained at similar values for a period of over three months. Electroencephalogram and cerebral magnetic resonance imaging (MRI) showed no abnormalities. Brain PET-scan disclosed bilateral striatal hypermetabolism. The patient was treated with methylprednisolone and low dose of acetylsalicylic acid. He improved markedly after six weeks of treatment, and choreic movements disappeared completely after two months. A control PET-scan performed at this time showed reversion of striated hypermetabolism to a normal pattern. The pathogenic aspects of this relatively rare case of chorea are discussed. [less ▲]

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See detailFluoride PET-CT.
Hustinx, Roland ULg; Beckers, Catherine ULg

in Fanti, Stefano; Farsad, Mohsen; Mansi, Luigi (Eds.) PET-CT Beyond FDG. (2010)

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See detailVisual fixation in the vegetative state: an observational case series PET study.
Bruno, Marie-Aurélie ULg; Vanhaudenhuyse, Audrey ULg; Schnakers, Caroline ULg et al

in BMC Neurology (2010), 10

BACKGROUND: Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether ... [more ▼]

BACKGROUND: Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether fixation is compatible with the diagnosis of the vegetative state (i.e., represents "automatic" subcortical processing) or is a sufficient sign of consciousness and higher order cortical processing. METHODS: We here studied cerebral metabolism in ten patients with chronic post-anoxic encephalopathy and 39 age-matched healthy controls. Five patients were in a vegetative state (without fixation) and five presented visual fixation but otherwise showed all criteria typical of the vegetative state. Patients were matched for age, etiology and time since insult and were followed by repeated Coma Recovery Scale-Revised (CRS-R) assessments for at least 1 year. Sustained visual fixation was considered as present when the eyes refixated a moving target for more than 2 seconds as defined by CRS-R criteria. RESULTS: Patients without fixation showed metabolic dysfunction in a widespread fronto-parietal cortical network (with only sparing of the brainstem and cerebellum) which was not different from the brain function seen in patients with visual fixation. Cortico-cortical functional connectivity with visual cortex showed no difference between both patient groups. Recovery rates did not differ between patients without or with fixation (none of the patients showed good outcome). CONCLUSIONS: Our findings suggest that sustained visual fixation in (non-traumatic) disorders of consciousness does not necessarily reflect consciousness and higher order cortical brain function. [less ▲]

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See detailCentral neuromodulation in cluster headache patients treated with occipital nerve stimulators: A PET study
Magis, Delphine ULg; Bruno, Marie-Aurélie ULg; Fumal, Arnaud ULg et al

in Acta Neurologica Belgica (2010), 110(Suppl 1), 17

OBJECTIVES: Use functional brain imaging to explore activity changes in centres involved in trigeminal pain processing and control before and after occipital neurostimulation in drug-resistant chronic ... [more ▼]

OBJECTIVES: Use functional brain imaging to explore activity changes in centres involved in trigeminal pain processing and control before and after occipital neurostimulation in drug-resistant chronic cluster headache patients. BACKGROUND: Occipital nerve stimulation (ONS) provides relief to about 60% of patients suffering from drug-resistant chronic cluster headache (drCCH). Its mode of action, however, remains elusive, but the long latency to meaningful effect suggests that ONS induces slow neuromodulation. METHODS: Ten drCCH patients underwent an 18FDG-PET scan after ONS durations varying between 0 and 30 months. All were scanned with ongoing ONS (ON) and with the stimulator switched OFF. RESULTS: After 6-30 months of ONS, 3 patients were pain free and 4 had a ≥ 90% reduction of attack frequency (responders). In patients overall compared to controls, several areas of the pain matrix were hypermetabolic: ipsilateral hypothalamus, midbrain and ipsilateral lower pons. All normalized after ONS, except the hypothalamus. Switching ON or OFF the stimulator had little influence on brain glucose metabolism. The perigenual anterior cingulate cortex (PACC) was hyperactive in ONS responders compared to non-responders. INTERPRETATION AND CONCLUSIONS: Metabolic normalization in the pain neuromatrix and lack of short-term changes induced by the stimulation support the hypothesis that ONS acts in drCCH through slow neuromodulatory processes. Selective activation in responders of PACC, a pivotal structure in the endogenous opioid system, suggests that ONS may restore balance within dysfunctioning pain control centres. That ONS is nothing but a symptomatic treatment might be illustrated by the persistent hypothalamic hypermetabolism which could explain why autonomic attacks may persist despite pain relief and why cluster attacks recur shortly after stimulator arrest. [less ▲]

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See detailDetecting consciousness in a total Locked-in syndrome: an active event related paradigm
Schnakers, Caroline ULg; Perrin, Fabien; Schabus, Manuel et al

in Neurocase : Case Studies in Neuropsychology, Neuropsychiatry & Behavioural Neurology (2009), 25

Total locked-in syndrome is characterized by tetraplegia, anarthria and paralysis of eye motility. In this study, consciousness was detected in a 21-year-old woman who presented a total locked-in syndrome ... [more ▼]

Total locked-in syndrome is characterized by tetraplegia, anarthria and paralysis of eye motility. In this study, consciousness was detected in a 21-year-old woman who presented a total locked-in syndrome after a basilar artery thrombosis (49 days post-injury) using an active event-related paradigm. The patient was presented sequences of names containing the patient's own name and other names. The patient was instructed to count her own name or to count another target name. Similar to 4 age- and gender-matched healthy controls, the P3 response recorded for the voluntarily counted own name was larger than while passively listening. This P3 response was observed 14 days before the first behavioral signs of consciousness. This study shows that our active event-related paradigm allowed to identify voluntary brain activity in a patient who would behaviorally be diagnosed as comatose. [less ▲]

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See detailOutils isotopiques pour les MICI : PET et PET/CT.
Hustinx, Roland ULg; Louis, Edouard ULg

in Côlon & Rectum (2009), 3

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See detailOutils isotopiques : TEP et TEP/TDM
Hustinx, Roland ULg

in Dupas, Jean-Louis; Louis, Edouard; Marteau, Philippe (Eds.) Maladies inflammatoires chroniques de l'intestin. (2009)

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