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Article ; Online: Hepatocellular Carcinoma: Current Imaging Modalities for Diagnosis and Prognosis.

Ronot, Maxime / Purcell, Yvonne / Vilgrain, Valérie

2019 Volume 64, Issue 4, Page(s) 934–950

Abstract: As opposed to most solid cancers, hepatocellular carcinoma (HCC) does not necessarily require histological confirmation. Noninvasive diagnosis is possible and relies on imaging. In cirrhotic patients, the diagnosis can be obtained in tumors displaying ... ...

Abstract	As opposed to most solid cancers, hepatocellular carcinoma (HCC) does not necessarily require histological confirmation. Noninvasive diagnosis is possible and relies on imaging. In cirrhotic patients, the diagnosis can be obtained in tumors displaying typical features that include non-rim arterial phase hyperenhancement followed by washout during the portal venous and/or delayed phases on CT or MR imaging. This pattern is very specific and, as such, has been endorsed by both Western and Asian diagnostic guidelines and systems. However, its sensitivity is not very high, especially for small lesions. Numerous ancillary features favoring the diagnosis of HCC may be depicted, including appearance after injection of hepatobiliary MR imaging contrast agents. These features increase confidence in diagnosis, but cannot be used as substitutes to liver biopsy. Aside from its diagnostic purpose, imaging also helps to assess tumor biology and patient outcome, by identifying features of local invasiveness. The purpose of this review article is to offer an overview of the role of imaging for the diagnosis and prognostication of HCC.
MeSH term(s)	Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/etiology ; Contrast Media ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/etiology ; Prognosis
Chemical Substances	Contrast Media
Language	English
Publishing date	2019-03-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-019-05547-0
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Article: Imaging of Cerebral Venous Thrombosis.

Sadik, Jean-Claude / Jianu, Dragos Catalin / Sadik, Raphaël / Purcell, Yvonne / Novaes, Natalia / Saragoussi, Edouard / Obadia, Michaël / Lecler, Augustin / Savatovsky, Julien

Life (Basel, Switzerland)

2022 Volume 12, Issue 8

Abstract: Cerebral venous thrombosis is a rare cause of stroke. Imaging is essential for diagnosis. Although digital subtraction angiography is still considered by many to be the gold standard, it no longer plays a significant role in the diagnosis of cerebral ... ...

Abstract	Cerebral venous thrombosis is a rare cause of stroke. Imaging is essential for diagnosis. Although digital subtraction angiography is still considered by many to be the gold standard, it no longer plays a significant role in the diagnosis of cerebral venous thrombosis. MRI, which allows for imaging the parenchyma, vessels and clots, and CT are the reference techniques. CT is useful in case of contraindication to MRI. After presenting the radio-anatomy for MRI, we present the different MRI and CT acquisitions, their pitfalls and their limitations in the diagnosis of cerebral venous thrombosis.
Language	English
Publishing date	2022-08-10
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life12081215
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Article ; Online: Neurologic Involvement of Patients with Coronavirus Disease 2019: Making the Most of MRI.

Purcell, Yvonne / Lecler, Augustin / Saragoussi, Edouard / Poiron, Emilie / Poillon, Guillaume / Savatovsky, Julien

Radiology

2020 Volume 297, Issue 1, Page(s) E239

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections ; Humans ; Italy ; Magnetic Resonance Imaging ; Pandemics ; Pneumonia, Viral ; Retrospective Studies ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-06-09
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2020202466
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Article ; Online: Lessons learnt from pathologic imaging correlation in the liver: an historical perspective.

Purcell, Yvonne / Copin, Pauline / Paradis, Valérie / Vilgrain, Valérie / Ronot, Maxime

The British journal of radiology

2019 Volume 92, Issue 1097, Page(s) 20180701

Abstract: Imaging and pathology can be considered as two sides of the same diagnostic coin. Yet, pathology remains the gold-standard technique for the diagnosis of most diseases. Nevertheless, significant and constant progress in imaging has been made thanks to ... ...

Abstract	Imaging and pathology can be considered as two sides of the same diagnostic coin. Yet, pathology remains the gold-standard technique for the diagnosis of most diseases. Nevertheless, significant and constant progress in imaging has been made thanks to fruitful rad-path correlations. The aim of this article is to show how much imaging has benefited from pathology and to illustrate the different ways in which imaging has evolved according to different types of pathological references. Imaging of hepatocellular carcinoma shows how image-based knowledge and expertise can be exploited to yield a non-invasive diagnosis approaching that of a fixed, robust pathological reference. Hepatocellular adenomas provide an example of the constant radiological evolutions triggered by changing pathological definitions. Finally, hepatic steatosis illustrates the possibility for imaging to surpass its historical reference, and become a new gold-standard. For these three examples, we have taken a historical approach to demonstrate how rad-path interminglement creates knowledge.
MeSH term(s)	Humans ; Liver/diagnostic imaging ; Liver/pathology ; Liver Diseases/diagnostic imaging ; Liver Diseases/pathology ; Pathology/methods ; Radiology/methods
Language	English
Publishing date	2019-01-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2982-8
ISSN	1748-880X ; 0007-1285
ISSN (online)	1748-880X
ISSN	0007-1285
DOI	10.1259/bjr.20180701
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Article ; Online: Automated Assessment of T2-Weighted MRI to Differentiate Malignant and Benign Primary Solid Liver Lesions in Noncirrhotic Livers Using Radiomics.

Starmans, Martijn P A / Miclea, Razvan L / Vilgrain, Valerie / Ronot, Maxime / Purcell, Yvonne / Verbeek, Jef / Niessen, Wiro J / Ijzermans, Jan N M / de Man, Rob A / Doukas, Michael / Klein, Stefan / Thomeer, Maarten G

Academic radiology

2023 Volume 31, Issue 3, Page(s) 870–879

Abstract: Rationale and objectives: Distinguishing malignant from benign liver lesions based on magnetic resonance imaging (MRI) is an important but often challenging task, especially in noncirrhotic livers. We developed and externally validated a radiomics model ...

Abstract	Rationale and objectives: Distinguishing malignant from benign liver lesions based on magnetic resonance imaging (MRI) is an important but often challenging task, especially in noncirrhotic livers. We developed and externally validated a radiomics model to quantitatively assess T2-weighted MRI to distinguish the most common malignant and benign primary solid liver lesions in noncirrhotic livers. Materials and methods: Data sets were retrospectively collected from three tertiary referral centers (A, B, and C) between 2002 and 2018. Patients with malignant (hepatocellular carcinoma and intrahepatic cholangiocarcinoma) and benign (hepatocellular adenoma and focal nodular hyperplasia) lesions were included. A radiomics model based on T2-weighted MRI was developed in data set A using a combination of machine learning approaches. The model was internally evaluated on data set A through cross-validation, externally validated on data sets B and C, and compared to visual scoring of two experienced abdominal radiologists on data set C. Results: The overall data set included 486 patients (A: 187, B: 98, and C: 201). The radiomics model had a mean area under the curve (AUC) of 0.78 upon internal validation on data set A and a similar AUC in external validation (B: 0.74 and C: 0.76). In data set C, the two radiologists showed moderate agreement (Cohen's κ: 0.61) and achieved AUCs of 0.86 and 0.82. Conclusion: Our T2-weighted MRI radiomics model shows potential for distinguishing malignant from benign primary solid liver lesions. External validation indicated that the model is generalizable despite substantial MRI acquisition protocol differences. Pending further optimization and generalization, this model may aid radiologists in improving the diagnostic workup of patients with liver lesions.
MeSH term(s)	Humans ; Retrospective Studies ; Radiomics ; Magnetic Resonance Imaging/methods ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology
Language	English
Publishing date	2023-08-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1355509-1
ISSN	1878-4046 ; 1076-6332
ISSN (online)	1878-4046
ISSN	1076-6332
DOI	10.1016/j.acra.2023.07.024
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Article ; Online: Influence of pretreatment tumor growth rate on objective response of hepatocellular carcinoma treated with transarterial chemoembolization.

Purcell, Yvonne / Sartoris, Riccardo / Paradis, Valérie / Vilgrain, Valérie / Ronot, Maxime

Journal of gastroenterology and hepatology

2019 Volume 35, Issue 2, Page(s) 305–313

Abstract: Background and aim: The study aims to assess the influence of pretreatment tumor growth rate (TGR) on modified response evaluation criteria in solid tumors (mRECIST) objective response (OR) after a first session of selective transarterial ... ...

Abstract	Background and aim: The study aims to assess the influence of pretreatment tumor growth rate (TGR) on modified response evaluation criteria in solid tumors (mRECIST) objective response (OR) after a first session of selective transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Methods: One hundred fifteen patients (101 men [88%], mean 65.1 ± 10.5 years [range 26-87]) with 169 tumors (mean 34.2 ± 29.3 mm [10-160]), undergoing a first session of selective TACE for the treatment of HCC between 2011 and 2016, were included. TGR was calculated as the percentage change in tumor volume per month (%/month) on imaging before treatment. TGR cut-off for prediction of OR was identified by receiver operating characteristic curve analysis. Results: Overall 88/189 (52%) and 46/189 (27%) tumors showed complete response (CR) and partial response (PR) (OR rate 79%), while 32/189 (19%) showed stable disease (SD), and 3/189 (2%) were progressive disease (PD) on computed tomography at 1-month post-TACE. The mean pretreatment TGR was 12.0 ± 15.4 (-3.2-90.4) %/month. TGR of tumors showing CR, PR, SD, and PD was a mean 13.2 ± 16.4%, 12.1 ± 15.1%, 5.3 ± 4.5%, and 44.8 ± 20.4%, respectively (P < 0.001). The three tumors showing PD had TGR values > 20%/month. TGR was significantly higher in tumors with OR (12.8 ± 15.9% vs 5.3 ± 4.5% in SD, P = 0.009). A cut-off value of 6.5%/month had the highest predictive value of OR (AUROC 0.65 ± 0.05, P = 0.009). Conclusion: Pretreatment TGR is highly variable in HCC before TACE with a U-shaped distribution for the prediction of tumor response. It provides insight into tumor biology that may be used during pretreatment workup to help stratify patients.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic/methods ; Female ; Humans ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy ; Male ; Middle Aged
Language	English
Publishing date	2019-08-20
Publishing country	Australia
Document type	Journal Article
ZDB-ID	632882-9
ISSN	1440-1746 ; 0815-9319
ISSN (online)	1440-1746
ISSN	0815-9319
DOI	10.1111/jgh.14816
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Zs.A 2180: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Targeted and non-targeted liver biopsies carry the same risk of complication.

Maheux, Anna / Purcell, Yvonne / Harguem, Sana / Vilgrain, Valérie / Ronot, Maxime

European radiology

2019 Volume 29, Issue 11, Page(s) 5772–5783

Abstract: Objectives: To reappraise the rate of and risk factors for complications of targeted and non-targeted US-guided liver biopsy in a large series.: Methods: We analyzed 2405 liver biopsies performed in 2137 patients (58% males, mean age 54 ± 15 years ... ...

Abstract	Objectives: To reappraise the rate of and risk factors for complications of targeted and non-targeted US-guided liver biopsy in a large series. Methods: We analyzed 2405 liver biopsies performed in 2137 patients (58% males, mean age 54 ± 15 years old) between January 2010 and December 2015. Biopsies were performed for focal liver lesions characterization (targeted) or chronic liver disease assessment (non-targeted). Clinical, laboratory, and technical data were recorded. For targeted biopsies, we also recorded the largest diameter, location, enhancement pattern, and pathology. Advert events were divided into marked symptoms and complications. Those requiring specific treatment (embolization or surgery) were considered as severe. Results: A total of 1283 (53%) targeted and 1122 (47%) non-targeted biopsies were performed. Marked symptoms occurred after 134 biopsies (5.6%) (95 (7.4%) targeted and 39 (3.5%) non-targeted, p < 0.001), the most common being pain (109/134). Complications occurred after 38 biopsies (1.6%) (24 (1.9%) targeted and 14 (1.2%) non-targeted, p = 0.253) and were severe in 13 patients. In univariate analysis, prothrombin time (p = 0.006), serum creatinine level (p < 0.001), largest lesion diameter (p < 0.001), and tumor pathology (p = 0.040) were associated with the occurrence of complications but not platelet count or lesion enhancement pattern. In multivariate analysis, only the largest lesion diameter was retained (OR 1.014 [1.002-1.026], p = 0.018). Conclusion: The rate of advert events after US-guided liver biopsy was low, with no difference between targeted and non-targeted biopsies. When focusing on targeted biopsies, the largest lesion diameter but not enhancement pattern appeared as the main risk factor. Key points: • Targeted and non-targeted liver biopsies are associated with the same observed risk of complication. • Arterial phase hyperenhanced tumors on contrast-enhanced CT or MRI are not associated with a higher risk of complication when compared with non-hyperenhanced ones. • A high serum creatinine level is associated with a higher risk of complication and should motivate strict post-biopsy surveillance.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle/adverse effects ; Biopsy, Needle/methods ; Chronic Disease ; Embolization, Therapeutic/statistics & numerical data ; Female ; Hepatectomy/statistics & numerical data ; Humans ; Image-Guided Biopsy/adverse effects ; Image-Guided Biopsy/methods ; Liver Diseases/pathology ; Liver Diseases/therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Postoperative Complications/etiology ; Prothrombin Time ; Risk Factors ; Ultrasonography, Interventional/adverse effects ; Ultrasonography, Interventional/methods ; Young Adult
Language	English
Publishing date	2019-05-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-019-06227-3
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Article: Neurological Involvement of COVID-19 Patients: Making the Most of MRI

Purcell, Yvonne / Lecler, Augustin / Saragoussi, Edouard / Poiron, Emilie / Poillon, Guillaume / Savatovsky, Julien

Radiology

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #591392
Database	COVID19

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Article: Neurologic Involvement of Patients with Coronavirus Disease 2019: Making the Most of MRI

Purcell, Yvonne / Lecler, Augustin / Saragoussi, Edouard / Poiron, Emilie / Poillon, Guillaume / Savatovsky, Julien

Radiology

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #591392
Database	COVID19

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Article: Hepatocellular carcinoma surveillance: Eastern and Western perspectives.

Purcell, Yvonne / Copin, Pauline / Paulatto, Luisa / Pommier, Romain / Vilgrain, Valérie / Ronot, Maxime

Ultrasonography (Seoul, Korea)

2018 Volume 38, Issue 3, Page(s) 191–199

Abstract: Eastern and Western guidelines for the management of hepatocellular carcinoma (HCC) are known to significantly differ on many points, because they reflect different diagnostic and therapeutic approaches to this cancer. Importantly, these guidelines are ... ...

Abstract	Eastern and Western guidelines for the management of hepatocellular carcinoma (HCC) are known to significantly differ on many points, because they reflect different diagnostic and therapeutic approaches to this cancer. Importantly, these guidelines are primarily consensus-driven when it comes to surveillance, both in term of the tests used and surveillance program design. The main difference between East and West lies in clinical practice, as several Eastern countries implement coordinated and systematic surveillance programs, while most Western countries rely on individual adherence to surveillance recommendations. This review article presents an overview of the evidence supporting surveillance programs for HCC, with a particular focus on the efficacy, cost-effectiveness, and consequences of this approach for patient survival. Western and Eastern guideline recommendations are discussed.
Language	English
Publishing date	2018-10-28
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2775801-1
ISSN	2288-5943 ; 2288-5919
ISSN (online)	2288-5943
ISSN	2288-5919
DOI	10.14366/usg.18043
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