Cancer de la prostate : utilité de la TEP-TDM à la F-fluorocholine

In oncology, positron emission computed tomography (PET/CT) has become an essential tool for initial staging, response evaluation and follow-up of cancer patients. Most of the frequent tumors (lung, breast, esophagus, and lymphomas) are highly avid for ¹⁸F-fluorodeoxyglucose (¹⁸FDG), but prostate cancer has not demonstrated significant uptake of FDG. The development of new tracers labeled with ¹⁸F such as choline analogs allowed already to obtain interesting results particularly in patients with biological relapse and inconclusive conventional imaging work-up. The impact of ¹⁸F-flurocholine PET/CT on patient management needs to be validated in large studies, but many centers use already this examination in order to guide further management, including radiotherapy planning.     

Cancer de prostate métastatique résistant à la castration : le point de vue de l’oncologue médical

Most of patient suffering from a prostate cancer will develop a castration resistance. In this common and clinically challenging situation, chemotherapy was not considered very useful until mid 2000s. Docetaxel is now recognized as a standard of care, improving overall survival and quality of life. However, new drugs are needed. Two compounds (cabazitaxel and abiraterone) are now underway to official registration and an autologous vaccin strategy (Sipuleucel) demonstrated a benefit in survival. Based on a greater knowledge of biology, many other agents are currently under development, such as new specific peripheral anti-androgens, anti-angiogenic therapies, or proteasome inhibitors. All these new drugs are promising and may provide more efficient therapies against this incurable disease in the near future.     

Introduction à l’étude du site de Longgupo

The site of Longgupo, discovered in 1984, is located south of the crossing of the Three Gorges of the Yangtze, in the eastern part of Chongqing Province. Situated on the limestone slope of the Miaoyu Valley, three excavation campaigns have been carried out since 1985. The first two seasons took place from 1985–1988 and 1997–1998, directed by W.B. Huang and the last campaign from 2003–2006 by E. Boëda and Y.M. Hou. After the first two campaigns, the presence of several bones, with an estimated age of 1.9 My, notably including a mandible fragment attributed to a hominid² and the discovery of more than 20 lithic artifacts incited not only great interest in the scientific community, but controversy as well since these data contradicted diffusion models of the first hominids out of Africa. Paleoanthropological data often being privileged over other data, including lithic artifacts, the anthropic nature of the site was contested. Yet the few artifacts from the initial excavations irrefutably demonstrate their manufacture by humans, in particular those in exogenous stone. To definitively re-establish the authenticity of this site by applying the latest investigative methods, a new Franco-Chinese campaign was organized. The objective of the 2003–2006 field seasons focused on understanding and analysis of the archaeological data in their geomorphological and stratigraphic contexts.     

Traitement de l’hyperthyroïdie par l’iode 131 : à propos de 280 cas

We report through this work the experience of nuclear medicine department at Ibn-Sina hospital (Rabat), in the treatment of hyperthyroidism with iodine-131. We retrospectively studied a cohort of 280 patients with hyperthyroidism, from several regions of Morocco between January 2001 and January 2010. A clinical examination and a serum assessment of TSHus, FT4 and FT3 have been made at baseline and at 3, 6, 12 and 24 months after radioiodine therapy. The activity of iodine-131 administered ranged from 296 to 740 MBq and depended on the pathology being treated, age, thyroid volume, intensity of clinical and biological hyperthyroidism and socioeconomic situation. Radioiodine therapy has often been proposed as a treatment for second or third intention, 71 patients were initially treated with iodine-131, while 209 patients had received iodine-131 after failure of medical treatment and/or recurrence after surgical treatment. Graves’ disease was the most common etiology (60%), followed by toxic adenoma (20%), and multinodular toxic goiter (13%). The therapeutic efficacy of a single dose of radioiodine evaluated after a 6-months follow-up was 92% in Graves’ disease, 98% in toxic adenomas and 97% in toxic multinodular goiter. No acute complication was observed. Taking into account our socioeconomic context, radioiodine therapy remains the preferred treatment of hyperthyroidism in our country with good value vs. price and excellent tolerance.     

Application d'une méthode d'analyse du territoire à partir de la situation des marqueurs graphiques à l'intérieur de la Péninsule Ibérique : le Tage International

This paper, analyses the graphic evidences of the boundaries of Tagus between Spain and Portugal from the perspective of the model defended by our team. This model proposes the existence of the relationship between graphic markers: paintings, engravings in the open air, decorations over dolmens and menhirs, understood as a compact ideological group fixed in the organization social system of European producing people and metallurgical that occupying this landscape. This argument attempt to verify the possibilities of applying a pre-defined model in an area in which have been developed investigation models, focused to study megalithic monuments, menhirs, habitational areas, paints and engravings that shows symbolic expressions of the tradition to justify the property of rich areas in natural resources in what metallurgical have a remarkable importance.     

Imagerie hybride dans l’embolie pulmonaire aiguë : apport de la TDM couplée à la tomoscintigraphie de ventilation et de perfusion

Purpose

V/P-SPECT lung scan can be combined with computerized tomography (CT) from hybrid camera. We investigated if CT data could be use only with perfusion scans for the diagnosis of acute pulmonary embolism (PE).

Patients and methods

In a retrospective study, 75 consecutives patients, referred for suspicion of PE, underwent SPECT ventilation and perfusion scans coupled with a CT on Symbia T2. The perfusion images (P-SPECT) were classified as normal or abnormal with systematized (segmental and sub-segmental) or not systematized perfusion abnormalities. The ventilation images (V-SPECT) were considered as normal or abnormal in light of perfusion defects. The same was done for CT images. Correlations between V-SPECT and CT were studied.

Results

Hence, 28 patients had a normal P-SPECT and did not have PE. Patients (47) had an abnormal P-SPECT (among them, 16 turned out to have PE and 31 did not). There were 192 perfusion abnormalities of which 81 were segmental and 81 sub-segmental. Corresponding to these abnormalities, V-SPECT and CT were concordant in 83 % of the cases. When not-concordant, V-SPECT abnormalities with normal CT were found in 14 % of the cases and CT abnormalities with normal V-SPECT were found in 3 % of the cases. According to the EANM guidelines for PE diagnosis, sensitivity was 88 % and specificity 93 % with V/P-SPECT and 100 % and 83 % respectively with CT/P-SPECT (p = NS).

Conclusion

V/P-SPECT remains slightly more specific for the diagnosis of PE. However, this study demonstrates that CT/P-SPECT obtained with hybrid camera could be used for PE diagnosis with performances similar to V/P-SPECT. If these results would be confirmed on larger populations, this could lead to a significant reduction of scanning time which would improve patient comfort and reduce the camera load.     

Entre le Nord et le Sud—un site à pointes à dos de la fin de l’Allerød : Bad Breisig, district de Ahrweiler (vallée moyenne du Rhin, RFA)

Due to unparalleled conditions of preservation below volcanic ashes of the late glacial Laacher-See volcano, the Central Rhineland region, located at the geographic hinge between the North German Lowlands and the Highland zone, permits detailed insights into the environmental and vegetational history of the Allerød-Interstadial and has produced fundamental data for the reconstruction of the way of life of hunter-gatherer groups of that time. The recently investigated site of Bad Breisig, dating to the final part of the Allerød, is the first record of a Late Glacial human settlement of the Central Rhineland after the disastrous environmental destruction caused by the eruption of the Laacher-See volcano. The site is an important chronostratigraphic and typological key in the understanding of the development of the Final Palaeolithic technocomplex with backed points in Central Europe.     

Autres applications de la MIBG : « applications de la scintigraphie de l’innervation myocardique à la 123-I-MIBG en neurologie »

Myocardial 123-I-metaiodobenzylguanidine (MIBG) imaging enables the assessment of postganglionic sympathetic cardiac innervation. Recently myocardial 123-I-MIBG scintigraphy has been found to be useful to distinguishing Parkinsońs disease (PD) from other akinetic rigid syndromes. The absence of published guidelines for cardiac 123-I-MIBG imaging makes standardization of procedures among individual users of this technique even more important. Cardiac MIBG study showed markedly decreased uptake in PD, dementia with Lewy bodies (DLB) and pure autonomic failure, which is a common feature of Lewy body disease. The cardiac MIBG uptake is severely impaired even in the early disease stage. Atypical parkinsonian syndromes, including Multiple System Atrophy, Progressive Supranuclear Palsy, and other, show modest reduction of cardiac MIBG uptake. The MIBG study can be used for differentiating patients with extrapyramidal signs and dementia, and might provide useful diagnostic information to discriminate DLB and Alzheime?s disease.