References of "COUCKE, Philippe"
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See detailAutomated multimodal volume registration based on supervised 3D anatomical landmark detection
Vandaele, Rémy ULiege; LALLEMAND, François ULiege; MARTINIVE, Philippe ULiege et al

in SCITEPRESS Digital Library (in press)

We propose a new method for automatic 3D multimodal registration based on anatomical landmark detection. Landmark detectors are learned independantly in the two imaging modalities using Extremely ... [more ▼]

We propose a new method for automatic 3D multimodal registration based on anatomical landmark detection. Landmark detectors are learned independantly in the two imaging modalities using Extremely Randomized Trees and multi-resolution voxel windows. A least-squares fitting algorithm is then used for rigid registration based on the landmark positions as predicted by these detectors in the two imaging modalities. Experiments are carried out with this method on a dataset of pelvis CT and CBCT scans related to 45 patients. On this dataset, our fully automatic approach yields results very competitive with respect to a manually assisted state-of-the-art rigid registration algorithm. [less ▲]

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See detailMultidisciplinary rehabilitation program after breast cancer: benefits on physical function, anthropometry and quality of life.
Leclerc, Anne-France ULiege; Foidart-Dessalle, Marguerite ULiege; Tomasella, Marco ULiege et al

in European Journal of Physical and Rehabilitation Medicine (2017), 53(5), 633-642

BACKGROUND: Different clinical trials show beneficial effects of physical training offered during and / or after breast cancer treatment. However, given the variety of side effects that may be encountered ... [more ▼]

BACKGROUND: Different clinical trials show beneficial effects of physical training offered during and / or after breast cancer treatment. However, given the variety of side effects that may be encountered, physical training could be combined with psychological, relational and social guidance. This kind of multidisciplinary program has been little studied so far. AIM: To determine the benefits of a three-month multidisciplinary rehabilitation program among women after breast cancer treatment. DESIGN: Controlled no-randomized trial. SETTING: University for outcomes, University Hospital Center for interventions. POPULATION: Two hundred and nine outpatients who have been treated for a primary breast carcinoma. METHODS: Patients were divided into a control group (n=106) and an experimental group (n=103) which has benefited from a rehabilitation program of three months including physical training and psycho-educational sessions. The assessments, performed before and after the program, included functional assessments ("Sit and Reach Test", maximal incremental exercise test and "Six-Minute Walk Test"), body composition measurements (body mass index (BMI) and body fat percentage) and a questionnaire (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30). RESULTS: After three months, flexibility, walking distance and all parameters measured during the maximal incremental exercise, except maximal heart rate, were significantly improved in the experimental group. The body fat percentage was significantly decreased and a significant improvement was observed for perceived health status (quality of life), functional role, emotional state, physical, cognitive and social functions and for most symptoms. In the control group, most of these improvements didn't appear and a significant increase in BMI and body fat percentage was observed. CONCLUSIONS: This trial identifies the benefits of a well detailed multidisciplinary rehabilitation program, including physical re-conditioning and psycho-educational sessions, with important improvements in functional capacity, body composition and the majority of functions and symptoms among women after breast cancer treatment. CLINICAL REHABILITATION IMPACT: Through its results, this study could contribute to the development of hospital quality standards for oncologic rehabilitation. Physiotherapists can efficiently propose this kind of multidisciplinary rehabilitation program. [less ▲]

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See detailMethodological approach for the implementation of a simulator in augmented reality in a radiation therapy department
Servotte, Jean-Christophe ULiege; Guillaume, Michèle ULiege; BOGA, Deniz ULiege et al

in International Journal of Healthcare Management (2017), 10(3), 154-159

Radiation therapy (RT) is one of the cornerstones for the treatment of cancer. In most countries RT machines are handled by professionals benefitting from an ad hoc training in theoretical knowledge as ... [more ▼]

Radiation therapy (RT) is one of the cornerstones for the treatment of cancer. In most countries RT machines are handled by professionals benefitting from an ad hoc training in theoretical knowledge as well as technical and non-technical skills. In Belgium, RT departments are hiring in nurses for this activity. In countries where there is a specified core curriculum for basic training of radiation technologist, this basic training falls short once in practice and there is an obvious requirement for a continuous updating of skills in order to keep up with the accelerating evolution of technology. Therefore, the decision has been taken to implement a simulator in augmented reality in the RT department in Liège, to face the double challenge i.e. basic professional training as well as continuous education in technical and nontechnical skills and Crew Resource Management. We describe a methodological approach to implement this simulator in augmented reality. [less ▲]

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See detailLa «Health Literacy»,un moyen pour réduire les inégalités sociales de santé
Bragard, Isabelle ULiege; COUCKE, Philippe ULiege; Pétré, Benoît ULiege et al

in Revue Médicale de Liège (2017), 72(1),

Health literacy (HL) is defined as ‘the knowledge, motivation, and competences to access, understand, appraise and apply health information in order to make judgments and take decisions in everyday life ... [more ▼]

Health literacy (HL) is defined as ‘the knowledge, motivation, and competences to access, understand, appraise and apply health information in order to make judgments and take decisions in everyday life concerning health care, disease prevention and health promotion to maintain or improve quality of life’. This concept begins to be recognized as a priority area for action at political level in Belgium. Indeed, a limited HL may affect health by leading, by example, with poorer management of chronic diseases, more hospital admissions and premature deaths. This paper addresses the question of HL evaluation, improvement interventions as well as the many challenges that remain in this area. HL seems fundamental to the development of better health management. It would allow patients to play a more active role in health care, to involve all health stakeholders, and to contribute to a more sustainable health system. Improving HL could allow better equal access to health care. [less ▲]

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See detailA non-randomized comparison study of self-hypnosis, yoga and cognitive behavioral therapy to reduce emotional distress in breast cancer patients
BRAGARD, Isabelle ULiege; Etienne, Anne-Marie ULiege; Faymonville, Marie-Elisabeth ULiege et al

in International Journal of Clinical and Experimental Hypnosis (2017), 65(2), 189-209

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See detailHealth literacy en Belgique : diagnostic et pistes d’interventions
Bragard, Isabelle ULiege; Pétré, Benoît ULiege; Coucke, Philippe ULiege et al

Conference (2016, December 14)

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See detailDistributed learning: Developing a predictive model based on data from multiple hospitals without data leaving the hospital – A real life proof of concept
JOCHEMS, Arthur; DEIST, Timo M.; VAN SOEST, Johan et al

in Radiotherapy & Oncology (2016)

Purpose: One of the major hurdles in enabling personalized medicine is obtaining sufficient patient data to feed into predictive models. Combining data originating from multiple hospitals is difficult ... [more ▼]

Purpose: One of the major hurdles in enabling personalized medicine is obtaining sufficient patient data to feed into predictive models. Combining data originating from multiple hospitals is difficult because of ethical, legal, political, and administrative barriers associated with data sharing. In order to avoid these issues, a distributed learning approach can be used. Distributed learning is defined as learning from data without the data leaving the hospital. Patients and methods:Clinical data from 287 lung cancer patients, treated with curative intent with chemoradiation (CRT) or radiotherapy (RT) alone were collected from and stored in 5 different medical institutes (123 patients at MAASTRO (Netherlands, Dutch), 24 at Jessa (Belgium, Dutch), 34 at Liege (Belgium, Dutch and French), 48 at Aachen (Germany, German) and 58 at Eindhoven (Netherlands, Dutch)). A Bayesian network model is adapted for distributed learning (watch the animation: http://youtu.be/nQpqMIuHyOk). The model predicts dyspnea, which is a common side effect after radiotherapy treatment of lung cancer. Results:We show that it is possible to use the distributed learning approach to train a Bayesian network model on patient data originating from multiple hospitals without these data leaving the individual hospital. The AUC of the model is 0.61 (95%CI, 0.51–0.70) on a 5-fold cross-validation and ranges from 0.59 to 0.71 on external validation sets. Conclusion: Distributed learning can allow the learning of predictive models on data originating from multiple hospitals while avoiding many of the data sharing barriers. Furthermore, the distributed learning approach can be used to extract and employ knowledge from routine patient data from multiple hospitals while being compliant to the various national and European privacy laws. [less ▲]

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See detailLE COMPROMIS ENTRE CULTURE NON PUNITIVE ET CULTURE JUSTE : ANALYSE DES SOUS-CULTURES DE SÉCURITÉ DES PATIENTS DANS UN SERVICE DE RADIOTHÉRAPIE
Kamto Kenmogne, Marius ULiege; Van Caillie, Didier ULiege; BOGA, Deniz ULiege et al

E-print/Working paper (2016)

The recent publication of the report "Medical error-the third leading causes of death in the US" (Makary & Daniel, 2016) has led to a renewed attention to the issue of patient safety in many developed ... [more ▼]

The recent publication of the report "Medical error-the third leading causes of death in the US" (Makary & Daniel, 2016) has led to a renewed attention to the issue of patient safety in many developed countries. The main issue involved is the role played by medical staff work in the occurrence of deaths from the medical care. According to Makary & Daniel, communication failures, misdiagnosis, bad judgments and inadequate skills have caused an average of 251,454 deaths per year in the United States in 2013. This report has taken the opposite view of the proponents of "No shame no blame" approach characterizing a non-punitive culture in which people are led to blame the system even though human responsibility is obvious. While the no-blame culture has often been presented as the success factor of an efficient safety /quality policy in medical settings (Amalberti et al., 2005; Woynar et al, 2007), discordant voices now stand to underline the limits of this approach (see eg Dekker & Breakey, 2016; Levitt, 2014 or Shojania & Dixon-Woods, 2013). These authors argue that the no-blame culture is difficult to implement in practice and suggest the implementation of a just culture that places more emphasis on individuals' behavior and performance and on their responsibility at work. In this context, this study examines – based on an in-depth longitudinal case study of a radiotherapy department that has implemented a reporting system for adverse events - the extent to which non-punitive culture and just culture can live together in the same organizational unit. By combining in-depth interviews with members of the quality team and a questionnaire survey administered to all staff, we evaluate the current safety subcultures in the service. The content analysis of the interviews and the treatment of questionnaires following the methodology of the Agency for Healthcare Research and Quality allows to see the emergence of three subcultures in the radiotherapy department studied: a reporting subculture, a non-punitive subculture and, to some extent, a just subculture. The study shows that the development of the safety culture in this department is based primarily on the establishment of a non-punitive subculture used as a way to encourage spontaneous reporting of adverse events. The reporting culture is therefore the more controlled dimension of the safety culture of the department. Concerning responsibility of workers, the study shows that they have no fear of punishment and are not even familiar with the term in the workplace. On the contrary, instead of a retributive just culture, the department has focused its safety culture on learning from mistakes and substantial just culture based on a system of worker participation in the preparation of procedures that prescribe the right way to work. [less ▲]

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See detailInfluence d'un programme de revalidation multidisciplinaire post-cancer du sein sur la fonction physique
Leclerc, Anne-France ULiege; Foidart-Dessalle, Marguerite ULiege; BURY, Thierry ULiege et al

in 9ème Congrès commun SFMES - SFTS : Abstract book (2016, September 22)

Objectif : Le cancer du sein ainsi que ses traitements sont à l'origine de nombreux effets secondaires indésirables, notamment sur la fonction physique. Cette étude a pour objectif de déterminer les ... [more ▼]

Objectif : Le cancer du sein ainsi que ses traitements sont à l'origine de nombreux effets secondaires indésirables, notamment sur la fonction physique. Cette étude a pour objectif de déterminer les bénéfices éventuels d’un programme de revalidation multidisciplinaire sur la santé physique des femmes ayant été traitées pour un cancer du sein et d'évaluer l'influence de certaines caractéristiques individuelles initiales sur la réponse du groupe expérimental au programme de revalidation. Matériel et méthodes : L'étude constitue un essai clinique contrôlé non-randomisé évaluant une population totale de 209 patientes, recrutées sur base du volontariat et réparties en deux groupes, soit un groupe contrôle (n = 106) et un groupe expérimental (n = 103). Ce dernier a bénéficié d’une revalidation de trois mois comprenant un entraînement physique supervisé à raison de trois séances par semaine et diverses sessions psycho-éducatives. Pour l'ensemble des participantes, des évaluations constituées d'une part de mesures physiques et fonctionnelles et d'autre part de mesures de composition corporelle ont été programmées à 0 et 3 mois. Celles-ci ont inclus un test de souplesse ("Sit and Reach"), un test d'effort maximal sur bicyclette ergométrique avec suivi cardio-respiratoire, un test de marche de six minutes et la mesure de l'indice de masse corporelle et du pourcentage de graisse corporelle. Afin d'affiner l'analyse, trois groupes ont également été constitués au sein du groupe expérimental à partir des caractéristiques individuelles de thérapie adjuvante (présence de chimiothérapie ou non), de chirurgie (mastectomie ou tumorectomie) et de délai de fin de traitement (délai ≤ 4 mois ou ≥ 8 mois). Résultats : Initialement, toutes les patientes présentent un état de déconditionnement physique, non influencé par le délai de fin de traitement ou par le type de chirurgie, mais bien influencé par la présence d'une chimiothérapie puisque la VO2max apparaît significativement plus faible dans ce cas. Au terme des trois mois, la souplesse (p < 0,0001), la consommation maximale d'oxygène (p < 0,0001), la puissance maximale aérobie (p < 0,0001) et la distance de marche en six minutes (p < 0,0001) s’améliorent significativement au sein du groupe expérimental. Au sein du groupe contrôle, aucune amélioration n'est constatée, excepté pour la distance de marche (p = 0,0031). Par ailleurs, une augmentation significative de l'indice de masse corporelle (p = 0,034) et du pourcentage de graisse corporelle (p = 0,034) est observée au sein du groupe contrôle alors que ce paramètre diminue significativement au sein du groupe expérimental (p = 0,037). Enfin, toutes les patientes du groupe expérimental présentent un même profil de progression quelles que soient leurs caractéristiques individuelles initiales. Conclusion : Cette étude démontre ainsi les effets bénéfiques, tant sur le plan physique que de la composition corporelle, d’une prise en charge multidisciplinaire chez des femmes ayant été traitées pour le cancer du sein. [less ▲]

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See detailLa médecine du futur en question(s): les objets connectés
Coucke, Philippe ULiege

in Healthcare Executive (2016), 88(AOUT-SEPTEMBRE 2016), 28-29

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See detailThe Influence of Treatment Position (Prone vs. Supine) on Clip Displacement, Seroma, Tumor Bed and Partial Breast Target Volumes: Comparative Study
Lakosi, Ferenc; GULYBAN, Akos ULiege; BEN MUSTAPHA, Selma ULiege et al

in Pathology Oncology Research (2016), 22(3), 493-500

To analyse the displacement of surgical clips in prone (Pr) position and assess the consequences on target volumes and integral dose of partial breast irradiation (PBI). 30 post-lumpectomy breast cancer ... [more ▼]

To analyse the displacement of surgical clips in prone (Pr) position and assess the consequences on target volumes and integral dose of partial breast irradiation (PBI). 30 post-lumpectomy breast cancer patients underwent CT imaging in supine (Su) and Pr. Clip displacements were measured by the distances from the clips to a common fix bony reference point. On each dataset, the tumour bed (TB = clips ± seroma), clinical target volume (CTV = TB + 1.5 cm) and planning target volumes (PTV = CTV + 1 cm) for PBI were determined and the volume pairs were compared. Furthermore estimation of integral dose ratio (IDR) within the breast from tangential treatment was performed as the ratio of the irradiated breast volume and the volume encompassing all clips. Clips close to the chest wall (CW) in Su showed significantly less displacement in Pr. The mean volumes of seroma, CTV and PTV were significantly higher in Pr than in Su. The PTV volume difference (Pr-Su) was significantly higher in patients with presence of seroma, deep clips and TB location in the superior-internal-quadrant (SIQ) and at the junction of superior quadrants (jSQ). In a multivariate analysis two factors remained significant: seroma and TB localization in SIQ-jSQ. The IDR was significantly larger in Su than in Pr (7.6 vs. 4.1 p < 0.01). Clip displacements varied considerably with respect to their relative position to the CW. In selected patients Pr position potentially leads to a significant increase in target volumes of PBI. Tangential beam arrangement for PBI should be avoided, not only in Su but in Pr as well in case of clip-based target volume definition. [less ▲]

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See detailFeasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment
Lakosi, Ferenc; GULYBAN, Akos ULiege; BEN MUSTAPHA, Selma ULiege et al

in Cancer Radiotherapie (2016), 3429

Purpose:Feasibility evaluation of the Sagittilt© prone breast board system (Orfit Industries, Wijnegem, Belgium) for radiotherapy focusing on patient and staff satisfaction, treatment time, treatment ... [more ▼]

Purpose:Feasibility evaluation of the Sagittilt© prone breast board system (Orfit Industries, Wijnegem, Belgium) for radiotherapy focusing on patient and staff satisfaction, treatment time, treatment reproducibility with the assessment of residual-intrafractional errors. Material and methods: Thirty-six patients underwent whole-breast irradiation in prone position. Seventeen received a sequential boost (breast: 42.56 Gy in 16 fractions, boost: 10 Gy in five fractions), while 19 patients received a concomitant boost protocol (breast/boost: 45.57/55.86 Gy in 21 fractions). Treatment verification included a daily online cone-beam CT (CBCT). In order to assess the residual and residual-intrafractional errors post-treatment CBCTs were performed systematically at the first five treatment sessions. Treatment time, patient comfort, staff satisfaction were also evaluated. Results: The pretreatment CBCT resulted in a population systematic error of 4.5/3.9/3.3 mm in lateral/longitudinal/vertical directions, while the random error was 5.4/3.8/2.8 mm. Without correction these would correspond to a clinical to planning target volume margin of 15.0/12.3/10.3 mm. The population systematic and random residual-intrafractional errors were 1.5/0.9/1.7 mm and 1.7/1.9/1.6 mm. Patient and staffs’ satisfaction were considered good and average. The mean treatment session time was 21 minutes (range: 13–40 min). Conclusion: The Sagittilt© system seems to be feasible for breast irradiation and well-tolerated by patients, acceptable to radiographers and reasonable in terms of treatment times. Set-up accuracy was comparable with other prone systems; residual errors need further investigations. [less ▲]

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See detailIs it possible to improve communication around radiotherapy delivery: A randomized study to assess the efficacy of team training?
Liénard, Aurore; Delevallez, France; Razavi, Darius et al

in Radiotherapy & Oncology (2016), 119(2), 361-367

Background and purpose: The aim of this study was to assess the efficacy of a 38-h communication skills training program designed for multidisciplinary radiotherapy teams. Materials and methods: Four ... [more ▼]

Background and purpose: The aim of this study was to assess the efficacy of a 38-h communication skills training program designed for multidisciplinary radiotherapy teams. Materials and methods: Four radiotherapy teams were randomly assigned to a training program or to a waiting list. Assessments were scheduled at baseline (T1) and then after the training was completed or four months later (T2), respectively. Communication around radiotherapy delivery was assessed based on audio recordings of the first and last radiotherapy sessions in order to assess team members’ communication skills and the expression of concerns by breast cancer patients (analyzed with content analysis software LaComm). Results: 198 radiotherapy sessions were recorded. During the first radiotherapy sessions, members of the trained teams exhibited more assessment skills (p = 0.048), provided more setting information (p < 0.001), and used more social words (p = 0.019) compared to the members of the untrained teams. During the last radiotherapy session, members of the trained teams used more assessment skills (p = 0.004) and patients interacting with members of the trained teams expressed more sadness words (p = 0.023). Conclusion: Training of multidisciplinary teams has the potential to transfer skills that affect the short exchanges that take place around radiotherapy delivery. [less ▲]

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See detailImpacts of Ionizing Radiation on the Different Compartments of the Tumor Microenvironment
Leroi, Natacha ULiege; LALLEMAND, François ULiege; COUCKE, Philippe ULiege et al

in Frontiers in Pharmacology (2016), 7

During the last decade, the initial cancer cell-centered view of tumors has greatly evolved to an integrated vision of tumor biology taking into account the key contribution of the TME. Obviously, the ... [more ▼]

During the last decade, the initial cancer cell-centered view of tumors has greatly evolved to an integrated vision of tumor biology taking into account the key contribution of the TME. Obviously, the different compartments of TME are closely related and contribute not only to tumor progression, but also to its response to treatments. Importantly, the TME evolves over time during the different steps of cancer development and is also affected by different therapeutic modalities. Although, improvements have been achieved regarding RT delivery to the primary tumor, ionizing radiation also target nontumor cells that influence tumor growth and metastatic dissemination. Different approaches have been proposed to overcome the radioresistance of cancer cells. The TME-mediated radioresistance is now the object of researches, which has been elegantly reviewed recently by Barker et al. (2015) and severalarticles pointed out the importance of treatments that modify the TME and likely radiosensitize tumor (Ansiaux et al., 2005; Crokart et al., 2005b; Frérart et al., 2008). However, the impact of anti-cancer treatments on the TME and consequently on the tumor phenotype, response to treatment and metastases, is often neglected. Here we pointed out the impact of RT on the TME. Recent findings emphasize the interest to optimize RT (i.e., dose per fraction) and timing of surgery (Leroi et al., 2015; Surace et al., 2015) in order to prevent metastatic spreading. The future challenge in RT will be to define the most appropriate combinations between RT, and other therapeutic modalities with the optimal sequence and timing of treatments. In this context, investigation of the TME-related acquired resistance will be essential and will provide important innovative data. [less ▲]

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See detailFeasibility study of repetitive diffusion MRI after Neoadjuvant radiotherapy for following tumor microenvironment.
LALLEMAND, François ULiege; Leroi, Natacha ULiege; Bahri, Mohamed Ali ULiege et al

Conference (2016, March 22)

Purpose/Objective. Neoadjuvant radiotherapy (NeoRT) improves tumor local control and tumor resection in many cancers. The timing between the end of the NeoRT and surgery is mostly driven by the occurrence ... [more ▼]

Purpose/Objective. Neoadjuvant radiotherapy (NeoRT) improves tumor local control and tumor resection in many cancers. The timing between the end of the NeoRT and surgery is mostly driven by the occurrence of side effects or the tumor downsizing. We previously demonstrated in an in vivo model that the timing of surgery and the schedule of NeoRT influenced the tumor dissemination. Here, our aim is to evaluate with functional MRI (fMRI) the impact of the radiation treatment on the tumor microenvironment and subsequently to identify non-invasive markers helping to determine the best timing to perform surgery for avoiding tumor spreading. First, we needed to demonstrate the feasibility of repetitive MRI imaging after NeoRT in mice. Material/methods. We used two models of NeoRT we previously developed in mice: MDA-MB 231 and 4T1 cells implanted in the flank of mice. When tumors reached the planned volume, they are irradiated with 2x5 Gy and then surgically removed at different time points after RT. In the mean time between the end of RT and the surgical procedure, mice were imaged in a 9,4T Agilent® MRI. Diffusion Weighted (DW) -MRI was performed every 2 days between RT and surgery. For each tumors we acquired 8 slices of 1 mm thickness and 0.5 mm gap with an “in plane voxel resolution” of 0.5 mm. For DW-MRI, we performed FSEMS (Fast Spin Echo MultiSlice) sequences, with 9 different B-values (from 40 to 1000) and B0, in the 3 main directions. We also performed IVIM (IntraVoxel Incoherent Motion) analysis, in the aim to obtain information on intravascular diffusion, related to perfusion (F: perfusion factor) and subsequently tumor vessels perfusion. Results. As preliminary results, with the MBA-MB 231 we observed a significant increase of F at day 6 after irradiation than a decrease and stabilization until surgery. No other modifications of the MRI signal, ADC, D or D* were observed. We observed similar results with 4T1 cells, F increased at day 3 than returned to initial signal. The difference in the timing of the peak of F can be related to the difference in tumor growth between MBA-MB 231 and 4T1 (four weeks vs one week). Conclusion. For the first time, we demonstrate the feasibility of repetitive fMRI imaging in mice models after NeoRT. With these models, we show a significant peak of the perfusion factor (F) at day 6 or day 3. This change occurs between the two previous time points of surgery demonstrating a difference in the metastatic spreading. Indeed, after a NeoRT of 2X5Gy we observed more metastases in the lung when MDA-MB 231 tumor bearing mice are operated 4 days after RT compared to 11 days. These preliminary results are very promising for identifying noninvasive markers for determining the best timing for surgery. [less ▲]

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