Three‐Dimensional Metabolic and Radiologic Gathered Evaluation Using VR‐RENDER Fusion: A Novel Tool to Enhance Accuracy in the Localization of Parathyroid Adenomas

D’Agostino, Jacopo; Diana, Michele; Vix, Michel; Nicolau, Stéphane; Soler, Luc; Bourhala, Khalil; Hassler, S.; Wu, Hurng‐Sheng; Marescaux, Jacques

doi:10.1007/s00268-013-2021-x

Cited by 22 publications

(14 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is a non-interventional, monocentric, retrospective study involving patients with pHPT and negative/discordant parathyroid scintigraphy and neck US, who were assessed at the University of Strasbourg Hospital between May 2018 and October 2019 using integrated 18 F-FCH PET/4D-CT for identification of hyperfunctioning parathyroid glands and preoperative three-dimensional (3D) virtual neck explorations [ 20 , 21 ]. Patients with clinical and biological data missing at the time of PET/4D-CT and with a clinical and biological follow-up less than 6 months after surgery or PET/4D-CT investigation were excluded.…”

Section: Methodsmentioning

confidence: 99%

18F-Fluorocholine PET and Multiphase CT Integrated in Dual Modality PET/4D-CT for Preoperative Evaluation of Primary Hyperparathyroidism

Pretet

Rotania

Helali

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

The present retrospective study evaluates the diagnostic value of integrated 18F-Fluorocholine positron emission tomography/four-dimensional contrast-enhanced computed tomography (18F-FCH PET/4D-CT) as second-line imaging in preoperative work-up of primary hyperparathyroidism (pHPT), and compares 18F-FCH PET with 4D-CT. Patients with pHPT and negative/discordant first-line imaging addressed for integrated 18F-FCH PET/4D-CT were retrospectively selected. Sensitivity and detection rate (DR%) of 18F-FCH PET/CT, 4D-CT, and PET/4D-CT were calculated according to the per patient and per lesion analyses, and afterwards compared. Histology associated with a decrease more than 50% of perioperative parathyroid hormone (PTH) blood level was used as a gold standard. Persistent high serum PTH and calcium levels during a 6-month follow-up was considered as presence of pHPT in both operated and non-operated patients. 50 patients (55 glands) were included. 44/50 patients (88%) were surgically treated. On a per patient analysis, sensitivity was 93%, 80%, and 95%, and DR% was 82%, 68%, and 84%, respectively for PET/CT, 4D-CT, and PET/4D-CT. PET/CT was more sensitive than 4D-CT (p = 0.046). PET/4D-CT performed better than 4D-CT (p = 0.013) but was equivalent to PET/CT alone. On a per gland analysis, sensitivity PET/CT, 4D-CT, and PET/4D-CT was 88%, 66%, and 92%, and DR% was 79%, 57%, and 83%, respectively. PET/CT and PET/4D-CT were more sensitive than 4D-CT alone (p = 0.01, p < 0.001, respectively). However, PET/CT and PET/4D-CT performed similarly. In conclusion, 18F-FCH PET provides better identification of hyperfunctioning parathyroids than 4D-CT and the combination of both did not significantly improve diagnostic sensitivity. Further investigations involving larger populations are necessary to define the role of 18F-FCH PET/4D-CT as a “one-stop shop” second-line imaging in preoperative work-up of pHPT, especially considering the additional patient radiation exposure due to multi-phase CT.

show abstract

Section: Methodsmentioning

confidence: 99%

18F-Fluorocholine PET and Multiphase CT Integrated in Dual Modality PET/4D-CT for Preoperative Evaluation of Primary Hyperparathyroidism

Pretet

Rotania

Helali

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition to allowing to visualize resection planes and plan the procedure, the VR-RENDER ® software, developed at the Research Institute against Cancer of the Digestive System (IRCAD), can also calculate resection and future remnant volumes. It has been applied to minimally invasive liver resections (90,91), in video-assisted minimally invasive parathyroidectomies (92,93), and in duodeno-cephalopancreatectomy (94)(95)(96). A targeted therapy, surgical or ablative, can be simulated on the virtual model to plan the most adapted strategy.…”

Section: Table 6 Miscellaneous (Most Significant) Complicationsmentioning

confidence: 99%

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

Diana¹,

Schiraldi²,

Liu³

et al. 2016

Hepatobiliary Surg. Nutr.

Self Cite

View full text Add to dashboard Cite

Background: High intensity focused ultrasound (HIFU) is emerging as a valid minimally-invasive imageguided treatment of malignancies. We aimed to review to current state of the art of HIFU therapy applied to the digestive system and discuss some promising avenues of the technology.Methods: Pertinent studies were identified through PubMed and Embase search engines using the following keywords, combined in different ways: HIFU, esophagus, stomach, liver, pancreas, gallbladder, colon, rectum, and cancer. Experimental proof of the concept of endoluminal HIFU mucosa/submucosa ablation using a custom-made transducer has been obtained in vivo in the porcine model. Results:Forty-four studies reported on the clinical use of HIFU to treat liver lesions, while 19 series were found on HIFU treatment of pancreatic cancers and four studies included patients suffering from both liver and pancreatic cancers, reporting on a total of 1,682 and 823 cases for liver and pancreas, respectively. Only very limited comparative prospective studies have been reported. Conclusions:Digestive system clinical applications of HIFU are limited to pancreatic and liver cancer. It is safe and well tolerated. The exact place in the hepatocellular carcinoma (HCC) management algorithm remains to be defined. HIFU seems to add clear survival advantages over trans arterial chemo embolization (TACE) alone and similar results when compared to radio frequency (RF). For pancreatic cancer, HIFU achieves consistent cancer-related pain relief. Further research is warranted to improve targeting accuracy and efficacy monitoring. Furthermore, additional work is required to transfer this technology on appealing treatments such as endoscopic HIFU-based therapies.Keywords: High intensity focused ultrasound (HIFU); liver cancer; pancreatic cancer; miniature HIFU delivery system; endoluminal applications of HIFU; mucosa and submucosal ablations using HIFU

show abstract

“…It provides an independent interpretation of the DICOM images (i.e., it is blinded to the formal radiological report) and creates a 3D modeling of the patient's anatomy, based on a hierarchical semiautomatic segmentation of visible organs. [12][13][14] The first step of the segmentation delineates skin, trachea, lungs, arteries, veins, and bones. To do so, location and shape knowledge and rules have been translated into mathematical constraints (density, geometry, and topology).…”

Section: Imaging Techniquementioning

confidence: 99%

Original Preoperative Localization Technique of Parathyroid Adenomas by 3-Dimensional Virtual Neck Exploration

et al. 2021

Self Cite

View full text Add to dashboard Cite

Objective. Preoperative imaging in primary hyperparathyroidism (PHPT) is essential for planning of parathyroidectomy—particularly for selection of a minimally invasive approach. The objective of this cohort study was to evaluate the diagnostic precision of 3D virtual neck exploration (3D-VNE), to evaluate its impact on choice of surgical approach, and to document the correlation with long-term outcomes. Methods. 235 consecutive patients with PHPT were studied (January 2014 to December 2018), with 6-month follow-up. 220 patients had a preoperative computed tomography (CT), 172 of these had a 3D-VNE based on the CT, and 226 patients had a Tc-99m sestamibi scan. Results. Sensitivity of exact, per gland, adenoma localization was 57.09% (95% CI: 50.85–63.10%) for nonspecialized radiologist interpretation of CT scan, 58.17% (95% CI: 51.99–64.10%) for Tc-99m sestamibi scan, and 90.21% (95% CI: 85.21–93.64%) for 3D-VNE, and thereby favoring 3D-VNE compared to CT scan alone (OR 34.5, 95% CI: 9.19–290.56%, P < 2.2 × 10−16) and to Tc-99m sestamibi scan (OR 16.25, 95% CI: 6.05–61.42%, P = 3.1 × 10−15). Specificity was 87.38% for CT scan, 86.36% for 3D-VNE, and 90% for Tc-99m sestamibi scan ( P > .05). The cure rate was 100%. The long-term recurrence rate (RR) was 2.978%. The RR was 1.324% in the video-assisted parathyroidectomy group of 151 patients and 5.952% in the group of 84 patients with cervicotomy ( P = .0459). Conclusion. CT-based 3D-VNE proved to be the most accurate localizing study in PHPT and aided in selecting patients for targeted minimally invasive parathyroidectomy, which was associated with the lower recurrence rate. 3D-VNE could be proposed as a first-line imaging study in patients with PHPT.

show abstract

Three‐Dimensional Metabolic and Radiologic Gathered Evaluation Using VR‐RENDER Fusion: A Novel Tool to Enhance Accuracy in the Localization of Parathyroid Adenomas

Abstract: 3D-MeRGE and 3D-VNE showed high accuracy for localization of PAs. 3D-MeRGE performed better than MIBI or CT alone for detecting small adenomas and those with a low PTH level.

Cited by 22 publications

References 37 publications

18F-Fluorocholine PET and Multiphase CT Integrated in Dual Modality PET/4D-CT for Preoperative Evaluation of Primary Hyperparathyroidism

18F-Fluorocholine PET and Multiphase CT Integrated in Dual Modality PET/4D-CT for Preoperative Evaluation of Primary Hyperparathyroidism

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

Original Preoperative Localization Technique of Parathyroid Adenomas by 3-Dimensional Virtual Neck Exploration

Contact Info

Product

Resources

About