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Reply to Letter to the Editor: "Ultra-low-dose vs. standard-of-care-dose CT of the chest in patients with post-COVID-19 conditions-a prospective intra-patient multi-reader study". 回复致编辑的信:"COVID-19 后患者的超低剂量与标准护理剂量胸部 CT--一项前瞻性患者内部多读片机研究"。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-04 DOI: 10.1007/s00330-024-11066-y
Christian Wassipaul, Helmut Ringl, Helmut Prosch, Benedikt H Heidinger
{"title":"Reply to Letter to the Editor: \"Ultra-low-dose vs. standard-of-care-dose CT of the chest in patients with post-COVID-19 conditions-a prospective intra-patient multi-reader study\".","authors":"Christian Wassipaul, Helmut Ringl, Helmut Prosch, Benedikt H Heidinger","doi":"10.1007/s00330-024-11066-y","DOIUrl":"10.1007/s00330-024-11066-y","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interval breast cancer rates for tomosynthesis vs mammography population screening: a systematic review and meta-analysis of prospective studies. 断层合成与乳腺放射摄影人群筛查的乳腺癌间隔率:前瞻性研究的系统回顾和荟萃分析。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-03 DOI: 10.1007/s00330-024-11085-9
Sol Libesman, Tong Li, M Luke Marinovich, Anna Lene Seidler, Alberto Stefano Tagliafico, Nehmat Houssami
{"title":"Interval breast cancer rates for tomosynthesis vs mammography population screening: a systematic review and meta-analysis of prospective studies.","authors":"Sol Libesman, Tong Li, M Luke Marinovich, Anna Lene Seidler, Alberto Stefano Tagliafico, Nehmat Houssami","doi":"10.1007/s00330-024-11085-9","DOIUrl":"https://doi.org/10.1007/s00330-024-11085-9","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to synthesise evidence from prospective studies of digital breast tomosynthesis (DBT) screening to assess its effectiveness compared to digital mammography (DM). Specifically, we examined whether DBT reduces interval cancer rates (ICRs) in population breast cancer screening.</p><p><strong>Materials and methods: </strong>We performed a systematic review and meta-analysis of DBT screening studies (identified from January 2013 to March 2024). We included both RCTs and non-randomised prospective studies that used an independent comparison for our primary outcome ICRs. The risk of bias was assessed with QUADAS-2. We compared the ICR, cancer detection rate (CDR), and recall rate of DBT and DM screening using random effects meta-analysis models. Subgroup analyses estimated outcomes by study design. Sensitivity analyses estimated absolute effects from relative effects.</p><p><strong>Results: </strong>Ten prospective studies (three RCTs, seven non-randomised) were eligible; all had a low risk of bias. There were 205,245 DBT-screened and 306,476 DM-screened participants with follow-up for interval cancer data. The pooled absolute ICR did not significantly differ between DBT and DM: -2.92 per 10,000 screens (95% CI: -6.39 to 0.54); however subsequent subgroup analysis indicated certain study designs may have biased this ICR estimate. Pooled ICR from studies that only sampled groups from the same time and region indicated DBT led to 5.50 less IC per 10,000 screens (95% CI: -9.47 to -1.54). Estimates from subgroup analysis that compared randomised and non-randomised trials did not significantly differ.</p><p><strong>Conclusion: </strong>This meta-analysis provides suggestive evidence that DBT decreases ICR relative to DM screening; further evidence is needed to reduce uncertainty regarding ICR differences between DBT and DM.</p><p><strong>Key points: </strong>Question Does DBT have long-term benefits over standard DM? Finding We find suggestive evidence in our primary analysis and stronger evidence in a follow-up analysis that DBT reduces interval cancers. Clinical relevance This meta-analysis provides the first indication that DBT may detect additional cancers that are clinically meaningful, based on suggestive evidence of a reduction in ICR. This finding does not preclude the simultaneous possibility of overdiagnosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Letter to the Editor: "Ultra-low-dose vs standard-of-care-dose CT of the chest in patients with post-COVID-19 conditions-a prospective intra-patient multi-reader study". 致编辑的信:"COVID-19 后患者胸部超低剂量 CT 与标准剂量 CT 的对比--一项前瞻性患者内部多读片机研究"。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-02 DOI: 10.1007/s00330-024-11065-z
Shritik Devkota, Mandeep Garg, Uma Debi
{"title":"Letter to the Editor: \"Ultra-low-dose vs standard-of-care-dose CT of the chest in patients with post-COVID-19 conditions-a prospective intra-patient multi-reader study\".","authors":"Shritik Devkota, Mandeep Garg, Uma Debi","doi":"10.1007/s00330-024-11065-z","DOIUrl":"10.1007/s00330-024-11065-z","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MR-contrast enhanced mammography (CEM) for follow-up of breast cancer patients: a "pros and cons" debate. 用于乳腺癌患者随访的磁共振对比增强乳腺造影术(CEM):"利弊 "之争。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-01 Epub Date: 2024-03-15 DOI: 10.1007/s00330-024-10684-w
Julia Camps-Herrero, Ruud Pijnappel, Corinne Balleyguier
{"title":"MR-contrast enhanced mammography (CEM) for follow-up of breast cancer patients: a \"pros and cons\" debate.","authors":"Julia Camps-Herrero, Ruud Pijnappel, Corinne Balleyguier","doi":"10.1007/s00330-024-10684-w","DOIUrl":"10.1007/s00330-024-10684-w","url":null,"abstract":"<p><p>Women with a personal history of breast cancer (PHBC) are at an increased risk of either a local recurrence or a new primary breast cancer. Thus, surveillance is essential for the detection of recurrent disease at the earliest possible stage, allowing for prompt treatment, and potentially improving overall survival. Nowadays, mammography follow-up is the only surveillance imaging technique recommended by international guidelines. Nevertheless, sensitivity of mammography is lower after breast cancer treatment, particularly during the first 5 years, due to increased density or post-treatment changes. Contrast-enhanced breast imaging techniques, such as MRI or contrast-enhanced mammography (CEM), are very sensitive to detect malignant enhancement, especially in dense breasts. This Special Report will provide arguments in favor of and against breast cancer follow-up with MRI or CEM, in a debate style between experts in Breast Imaging. Finally, the scientific points of pros and cons arguments will be summarized to help objectively decide the best follow-up strategy for women with a personal history of breast cancer. CLINICAL RELEVANCE STATEMENT: A personalized approach to follow-up imaging after conservative breast cancer treatment could optimize patient outcomes, using mammography as a baseline for most patients, and MRI or CEM selectively in patients with higher risks for a recurrence. KEY POINTS: • Women with a personal history of breast cancer are at an increased risk of either a local recurrence or a new primary breast cancer. • Breast cancer survivors may benefit from additional imaging with MRI/CEM, in case of increased risk of a second breast cancer, with dense breasts or a cancer diagnosis before age 50 years. • As survival after local recurrence seems to depend on the initial stage at diagnosis, imaging should be more focused on detecting tumors in the earliest stages.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Synthetic MRI and amide proton transfer-weighted MRI for differentiating between benign and malignant sinonasal lesions. 合成磁共振成像和酰胺质子传递加权磁共振成像用于区分鼻窦良性和恶性病变。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-01 Epub Date: 2024-03-16 DOI: 10.1007/s00330-024-10696-6
Ying Xiang, Qiujuan Zhang, Xin Chen, Honghong Sun, Xiaohui Li, Xiaocheng Wei, Jinman Zhong, Bo Gao, Wei Huang, Wenbin Liang, Haiqiao Sun, Quanxin Yang, Xiaoyong Ren
{"title":"Synthetic MRI and amide proton transfer-weighted MRI for differentiating between benign and malignant sinonasal lesions.","authors":"Ying Xiang, Qiujuan Zhang, Xin Chen, Honghong Sun, Xiaohui Li, Xiaocheng Wei, Jinman Zhong, Bo Gao, Wei Huang, Wenbin Liang, Haiqiao Sun, Quanxin Yang, Xiaoyong Ren","doi":"10.1007/s00330-024-10696-6","DOIUrl":"10.1007/s00330-024-10696-6","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the value of the synthetic MRI (SyMRI), combined with amide proton transfer-weighted (APTw) MRI for quantitative and morphologic assessment of sinonasal lesions, which could provide relative scale for the quantitative assessment of tissue properties.</p><p><strong>Methods: </strong>A total of 80 patients (31 malignant and 49 benign) with sinonasal lesions, who underwent the SyMRI and APTw examination, were retrospectively analyzed. Quantitative parameters (T1, T2, proton density (PD)) and APT % were obtained through outlining the region of interest (ROI) and comparing the two groups utilizing independent Student t test or a Wilcoxon test. Receiver operating characteristic curve (ROC), Delong test, and logistic regression analysis were performed to assess the diagnostic efficiency of one-parameter and multiparametric models.</p><p><strong>Results: </strong>SyMRI-derived mean T1, T2, and PD were significantly higher and APT % was relatively lower in benign compared to malignant sinonasal lesions (p < 0.05). The ROC analysis showed that the AUCs of the SyMRI-derived quantitative (T1, T2, PD) values and APT % ranged from 0.677 to 0.781 for differential diagnosis between benign and malignant sinonasal lesions. The T2 values showed the best diagnostic performance among all single parameters for differentiating these two masses. The AUCs of combined SyMRI-derived multiple parameters with APT % (AUC = 0.866) were the highest than that of any single parameter, which was significantly improved (p < 0.05).</p><p><strong>Conclusion: </strong>The combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions.</p><p><strong>Clinical relevance statement: </strong>Combining synthetic MRI with amide proton transfer-weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling.</p><p><strong>Key points: </strong>• Synthetic MRI and amide proton transfer-weighted MRI could differentiate benign from malignant sinonasal lesions based on quantitative parameters. • The diagnostic efficiency could be significantly improved through synthetic MRI + amide proton transfer-weighted imaging. • The combination of synthetic MRI and amide proton transfer-weighted MRI is a noninvasive method to evaluate sinonasal lesions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spontaneous perforation of the common bile duct: an uncommon complication of primary sclerosing cholangitis. 胆总管自发性穿孔:原发性硬化性胆管炎的罕见并发症。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-01 Epub Date: 2024-03-21 DOI: 10.1007/s00330-024-10704-9
Lucas Dargent, Sara Lemoinne, Karine Louvion, Pauline Iorio, Christophe Corpechot, Sanaâ El Mouhadi, Quentin Vanderbecq, Olivier Chazouillères, Lionel Arrivé
{"title":"Spontaneous perforation of the common bile duct: an uncommon complication of primary sclerosing cholangitis.","authors":"Lucas Dargent, Sara Lemoinne, Karine Louvion, Pauline Iorio, Christophe Corpechot, Sanaâ El Mouhadi, Quentin Vanderbecq, Olivier Chazouillères, Lionel Arrivé","doi":"10.1007/s00330-024-10704-9","DOIUrl":"10.1007/s00330-024-10704-9","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the MR features and prognosis of patients with an uncommon complication of primary sclerosing cholangitis (PSC) characterized by a spontaneous perforation of the common bile duct (CBD) resulting in a peri-biliary collection and a pseudo-cystic appearance of the CBD.</p><p><strong>Methods: </strong>A single-center cohort of 263 patients with PSC who had at least two MRIs between 2003 and 2022 and a minimum follow-up of 1 year was retrospectively analyzed. MRI data (characteristics of CBD perforation and MR features of PSC) and clinical data were assessed. Analysis of survival without liver transplantation according to type of PSC (classical or CBD spontaneous perforation) was performed according to the Kaplan-Meier method and the curves were compared using the Log-Rank test.</p><p><strong>Results: </strong>A total of nine (3.4%) PSC patients (5 males) had perforation of the CBD with a median age at diagnosis of 18 years compared to 33 years for the control group (p = 0.019). The peri-biliary collections were variable in appearance (fusiform or pedunculated), with a diameter ranging from 5 to 54 mm. All nine patients showed intra- and extra-hepatic bile duct involvement, dysmorphia, and high ANALI scores. The clinical course was characterized by numerous complications in most patients, and five patients (56%) underwent liver transplantation at a median time of 5 years from diagnosis, compared to 40 patients (16%) in the control group (p = 0.02).</p><p><strong>Conclusion: </strong>The spontaneous perforation of the common bile duct is an uncommon complication of primary sclerosing cholangitis that affects young patients and is associated with a poor prognosis.</p><p><strong>Clinical relevance statement: </strong>This uncommon complication of primary sclerosing cholangitis with perforation of the common bile duct resulting in a peri-biliary collection and a pseudo-cystic appearance of the common bile duct is characterized by a poor prognosis in younger patients.</p><p><strong>Key points: </strong>• Among 263 patients with primary sclerosing cholangitis (PSC), nine patients (3.6%) had an uncommon complication characterized on MRI by perforation of the common bile duct (CBD). • This perforation of the CBD was responsible in all nine cases for the formation of a peri-biliary collection, giving a pseudo-cystic appearance to the CBD. • The spontaneous perforation of the common bile duct is an uncommon complication of primary sclerosing cholangitis that affects young patients with a poor prognosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140184103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of smoking on the diagnostic results and complication rates of percutaneous transthoracic needle biopsy. 吸烟对经皮穿刺活检的诊断结果和并发症发生率的影响。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-01 Epub Date: 2024-03-25 DOI: 10.1007/s00330-024-10705-8
Woo Hyeon Lim, Jong Hyuk Lee, Hyungin Park, Chang Min Park, Soon Ho Yoon
{"title":"Effect of smoking on the diagnostic results and complication rates of percutaneous transthoracic needle biopsy.","authors":"Woo Hyeon Lim, Jong Hyuk Lee, Hyungin Park, Chang Min Park, Soon Ho Yoon","doi":"10.1007/s00330-024-10705-8","DOIUrl":"10.1007/s00330-024-10705-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of smoking with the outcomes of percutaneous transthoracic needle biopsy (PTNB).</p><p><strong>Methods: </strong>In total, 4668 PTNBs for pulmonary lesions were retrospectively identified. The associations of smoking status (never, former, current smokers) and smoking intensity (≤ 20, 21-40, > 40 pack-years) with diagnostic results (malignancy, non-diagnostic pathologies, and false-negative results in non-diagnostic pathologies) and complications (pneumothorax and hemoptysis) were assessed using multivariable logistic regression analysis.</p><p><strong>Results: </strong>Among the 4668 PTNBs (median age of the patients, 66 years [interquartile range, 58-74]; 2715 men), malignancies, non-diagnostic pathologies, and specific benign pathologies were identified in 3054 (65.4%), 1282 (27.5%), and 332 PTNBs (7.1%), respectively. False-negative results for malignancy occurred in 20.5% (236/1153) of non-diagnostic pathologies with decidable reference standards. Current smoking was associated with malignancy (adjusted odds ratio [OR], 1.31; 95% confidence interval [CI]: 1.02-1.69; p = 0.03) and false-negative results (OR, 2.64; 95% CI: 1.32-5.28; p = 0.006), while heavy smoking (> 40 pack-years) was associated with non-diagnostic pathologies (OR, 1.69; 95% CI: 1.19-2.40; p = 0.003) and false-negative results (OR, 2.12; 95% CI: 1.17-3.92; p = 0.02). Pneumothorax and hemoptysis occurred in 21.8% (1018/4668) and 10.6% (495/4668) of PTNBs, respectively. Heavy smoking was associated with pneumothorax (OR, 1.33; 95% CI: 1.01-1.74; p = 0.04), while heavy smoking (OR, 0.64; 95% CI: 0.40-0.99; p = 0.048) and current smoking (OR, 0.64; 95% CI: 0.42-0.96; p = 0.04) were inversely associated with hemoptysis.</p><p><strong>Conclusion: </strong>Smoking history was associated with the outcomes of PTNBs. Current and heavy smoking increased false-negative results and changed the complication rates of PTNBs.</p><p><strong>Clinical relevance statement: </strong>Smoking status and intensity were independently associated with the outcomes of PTNBs. Non-diagnostic pathologies should be interpreted cautiously in current or heavy smokers. A patient's smoking history should be ascertained before PTNB to predict and manage complications.</p><p><strong>Key points: </strong>• Smoking status and intensity might independently contribute to the diagnostic results and complications of PTNBs. • Current and heavy smoking (> 40 pack-years) were independently associated with the outcomes of PTNBs. • Operators need to recognize the association between smoking history and the outcomes of PTNBs.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140287253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Active surveillance of prostate cancer: MRI and beyond. 前列腺癌的主动监测:磁共振成像及其他
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-01 Epub Date: 2024-03-28 DOI: 10.1007/s00330-024-10717-4
Rossano Girometti, Francesco Giganti
{"title":"Active surveillance of prostate cancer: MRI and beyond.","authors":"Rossano Girometti, Francesco Giganti","doi":"10.1007/s00330-024-10717-4","DOIUrl":"10.1007/s00330-024-10717-4","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do we need to monitor B3 lesions? 我们需要监测 B3 病变吗?
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-01 DOI: 10.1007/s00330-024-11092-w
Maria Adele Marino, Antonio Portaluri, Carmelo Sofia
{"title":"Do we need to monitor B3 lesions?","authors":"Maria Adele Marino, Antonio Portaluri, Carmelo Sofia","doi":"10.1007/s00330-024-11092-w","DOIUrl":"https://doi.org/10.1007/s00330-024-11092-w","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Irreversible electroporation to bring initially unresectable locally advanced pancreatic adenocarcinoma to surgery: the IRECAP phase II study. 用不可逆电穿孔技术使最初无法切除的局部晚期胰腺癌接受手术治疗:IRECAP II 期研究。
IF 4.7 2区 医学
European Radiology Pub Date : 2024-10-01 Epub Date: 2024-03-18 DOI: 10.1007/s00330-024-10613-x
Jean-Pierre Tasu, Guillaume Herpe, Jérôme Damion, Jean-Pierre Richer, Bertrand Debeane, Mathilde Vionnet, Laetitia Rouleau, Michel Carretier, Aurélie Ferru, Pierre Ingrand, David Tougeron
{"title":"Irreversible electroporation to bring initially unresectable locally advanced pancreatic adenocarcinoma to surgery: the IRECAP phase II study.","authors":"Jean-Pierre Tasu, Guillaume Herpe, Jérôme Damion, Jean-Pierre Richer, Bertrand Debeane, Mathilde Vionnet, Laetitia Rouleau, Michel Carretier, Aurélie Ferru, Pierre Ingrand, David Tougeron","doi":"10.1007/s00330-024-10613-x","DOIUrl":"10.1007/s00330-024-10613-x","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the IRECAP study was to evaluate the rate of locally advanced pancreas cancer patients (LAPC) who could undergo R0 or R1 surgery after irreversible electroporation (IRE).</p><p><strong>Materials and methods: </strong>IRECAP study is a phase II, single-center, open-label, prospective, non-randomized trial registered at clinicaltrials.gov (NCT03105921). Patients with LAPC were first treated by 3-month neo-adjuvant chemotherapy in order to avoid inclusion of either patients with LAPC having become resectable after chemotherapy or patients with rapid disease progression. In cases of stable disease, IRE was performed percutaneously under CT guidance. Surgery was planned between 28 and 90 days after IRE. Tumor specimens were studied to evaluate the resection margins (R0/R1/R2).</p><p><strong>Results: </strong>Six men and 11 women were included (median age 61 years, range 37-77 years). No IRE-related death was observed. Ten patients (58%, 10/17) experienced 25 serious adverse events related to IRE. Four patients progressed between IRE and surgery and were excluded from surgery. Thirteen patients were finally operated, six withheld for pancreas resection, three for diffuse peritoneal carcinosis, two for massive vascular entrapment, and one for hepato-cellular carcinoma not diagnosed before surgery. Rate of R1-R0 was 35% (n = 6/17). Median overall survival was 31 months (95% CI; 4-undefined) for the six patients with R0/R1 resection and 21 months (95% CI; 4-25) for the 11 patients without resection or R2 resection (logrank p = 0.044).</p><p><strong>Conclusion: </strong>After neoadjuvant chemotherapy, IRE could provide R0 or R1 resection in 35% of LAPC, which seems to be associated with higher OS.</p><p><strong>Clinical relevance statement: </strong>After induction chemotherapy, stable locally advanced pancreatic cancers can be treated by irreversible electroporation, which could lead to a secondary 35% rate of R0 or R1 surgical resection which may be associated with a significantly higher overall survival.</p><p><strong>Key points: </strong>• In cases of unresectable LAPC (locally advanced pancreatic cancer), percutaneous irreversible electroporation (pIRE) is feasible (100% success rate of the procedure), but is associated with a 58% rate of grade 3-4 adverse events. • In patients with unresectable LAPC, pIRE could lead 35% of patients to R0-R1 surgical resection. • From IRE, median overall survival was 31 months (95% CI; 4-undefined) for the patients with R0/R1 resection and 21 months (95% CI; 4-25) for the patients without resection or R2 resection (logrank p = 0.044).</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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