The French experience of PSMA PET for the diagnosis of biological recurrence of prostate cancer

PSMA PET can only be performed in France in the context of a temporary authorization for use (ATU) granted by the ANSM only in the event of biological recurrence of prostate cancers with a normal or equivocal Fucyclovine or Choline PET scan. We present the experience of the Léon Bérard cancer centre and report on the experience of 3 other French centres that have published their results obtained within the framework of this ATU. Despite the absence of histological comparison of our results, the evidence of suspicious lesions on PSMA PET examination may induce changes in patient management in almost 2/3 of the patients. This is consistent with the already abundant results in the literature, which show a clear superiority of PSMA PET over Choline PET for the diagnosis of biological recurrence of prostate cancer.     

Joint SFMN/ANOCEF focus on 18F-FDOPA PET imaging in glioma: Current applications and perspectives

18F-FDOPA PET has demonstrated its additional value during the clinical course of glioma, at initial diagnosis, for treatment planning or follow-up. The aim of the current review was to summarize current applications of 18F-FDOPA PET in gliomas and constitute, as a perspective, a first step in harmonizing clinical practices in French centers. In France, the indication for 18F-FDOPA PET is restricted to the assessment of primary brain tumor recurrence. According to the literature, this indication could be expanded to primary diagnosis and, to a lesser extent, treatment monitoring. There is a real need to harmonize standard procedures among French centers. The objective is to increase the availability of data for this rare entity of glioma and to develop multi-parametric PET analyses (static, dynamic and textural), also known as radiomics, by using artificial intelligence algorithms. For this purpose, kinetics analysis with dynamic PET acquisition should be implemented in routine practice because it has demonstrated its additional value for initial diagnosis in gliomas. Therefore, this review proposes a workflow based on acquisition and reconstruction parameters that can be implemented in each center to increase the amount of standardized 18F-FDOPA PET data in neuro-oncology imaging in France. This would help in creating a national database and developing national multi-center studies that can respond to the challenge of using multi-parametric PET in glioma.     

TAPP与TEP治疗成人腹股沟疝的效果及对预后恢复的影响

摘要 目的：对比经腹腔腹膜前疝修补术（TAPP）与完全腹膜外疝修补术（TEP）治疗成人腹股沟疝的效果及对预后恢复的影响。方法：选取2018年3月至2021年5月期间本院收治的80例腹股沟疝成人患者为研究对象,按照随机数表法将其分为TAPP组（n=38）和TEP组（n=42）,分别给予TAPP、TEP治疗。对比两组患者术中及术后情况（手术时间、术中出血量、术后住院时间、恢复正常活动时间、疼痛程度）,以及精索血管情况,统计术后并发症发生率。结果：TEP组手术时间、术后住院时间、恢复正常活动时间短于TAPP组,术中出血量少于TAPP组（P<0.05）;两组患者疼痛视觉模拟法（VAS）评分呈下降趋势,且差异具有统计学意义（P<0.05）,但各时间点VAS评分比较无明显差异（P>0.05）;术前,两组患者精索静脉管径及精索静脉血流速度比较无明显差异（P>0.05）,术后4周,两组患者精索静脉管径均增大,静脉血流速度均减小,但TEP组上述指标优于TAPP组（P<0.05）;TAPP组并发症发生率（7.89%）略低于TEP组（9.52%）,差异无统计学意义（t=0.066,P=0.797）。结论：TAPP、TEP治疗成人腹股沟疝安全性均良好,但TEP术后恢复更快,且对精索静脉的影响较小。     

Fermentative glycolysis with purified Escherichia coli enzymes for in vitro ATP production and evaluating an engineered enzyme

Each of the twelve enzymes for glycolytic fermentation, eleven from Escherichia coli and one from Saccharomyces cerevisiae, have been over-expressed in E. coli and purified with His-tags. Simple assays have been developed for each enzyme and they have been assembled for fermentation of glucose to ethanol. Phosphorus-31 NMR revealed that this in vitro reaction accumulates fructose 1,6-bisphosphate while recycling the cofactors NAD⁺ and ATP. This reaction represents a defined ATP-regeneration system that can be tailored to suit in vitro biochemical reactions such as cell-free protein synthesis. The enzyme from S. cerevisiae, pyruvate decarboxylase 1 (Pdc1; EC 4.1.1.1), was identified as one of the major ‘flux controlling’ enzymes for the reaction and was replaced with an evolved version of Pdc1 that has over 20-fold greater activity under glycolysis reaction conditions. This substitution was only beneficial when the ratio of glycolytic enzymes was adjusted to suit greater Pdc1 activity.     

Illustrations cliniques en neurologie

The examples and clinical cases presented in this section are not intended to be considered as absolute models in terms of image quality or device parameter settings. They must initiate an individual analysis according to CT parameters and image quality. Nevertheless, they present practically different CT levels, which can be used according to the clinical context and the type of device.     

Indications et performances de la TEP/TDM au fluorure de sodium (FNA)

18F-NAF PET/CT is a relatively uncommon imaging procedure in France, for which indications are similar to those for bone scan and that shows substantial advantages when compared to it. In this review article, we propose to introduce this poorly known radiotracer, its validated indications, performances and some tips for interpretation that will be illustrated by 6 case reports.     

Évaluation de la réponse thérapeutique par tomographie par émission de positons (TEP) au fluoro-désoxyglucose (FDG) en oncologie-hématologie

¹⁸Fluoro-deoxyglucose (FDG) positron emission tomography (PET) is an imaging technique which studies the cellular glucidic metabolism. It is particularly indicated in oncology, especially for cancer diagnosis (with a potential prognosis interest) or detection of recurrence. Because of its functional approach to the tissues, its use has logically evolved into the evaluation of cancer treatments, both for the individual care of patients for clinical trials of new therapies. Also, it tends to displace conventional imaging in this indication, whose main limitation is not to assess the viability of residual masses, potentially necrotic or fibrous after treatment. However, the use of FDG-PET requires a rigorous methodology for both the exams achievement but also for the quality of their interpretation, including the choice of the comparison tool. Based on an increasing literature on the subject, were published and updated interpretation criteria for both lymphoma and solid cancers. For lymphoma, standardized assessment criteria were proposed in 2007 during an International Harmonize Project (IHP). For solid cancers, Positron Emission tomography Response Criteria In Solid Tumors (PERCIST) recommendations version 1.0 were recently proposed by an American workshop in 2009 in order to clarify and standardize practices.