Clinical utility and economic viability of a 3T MRI in an anti-cancer centre: The experience of the centre Oscar Lambret.

This paper will try and describe the installation of a 3T MRI in an anti-cancer centre. Functional sequences become indispensable in the assessment of targeted treatments. It is only possible to carry out these treatments on a routine basis in acceptable examination times with 3T. The technical constraints are overcome with third generation MRI and the improvement of the spatial resolution in examination times reduced by 30 to 50% increases patient comfort. Nevertheless, the financial constraints represent a major handicap. It is not possible to obtain an economic balance with rates based on the cost and depreciation of 1.5T imagers that are half the price.

[Functional MR Imaging: new tool to predict outcome for cervical carcinoma of uterus treated by concomitant radiochemotherapy?]. / IRM fonctionnelle: nouvel outil pour prédire la réponse des cancers du col utérin à la chimioradiothérapie concomitante?

The treatment of advanced cervix is concomitant radiochemotherapy. Local prognosis and global survival depend on tumoral volume, locoregional extension and radio sensitivity of the lesion. This one is function of tumoral hypoxia, tumoral interstitial pressure and existence of an anaemia. DCE-MRI allows to quantify pilot vascular parameters of the first two factors. Combined analysis: tumoral volume, anaemia and vascular parameters before and in the course of treatment allows a strong correlation with the risk of local recurrence and global survival.

[Clip migration after stereotactic macrobiopsy and presurgical localization: technical considerations and tricks]. / Déplacement de clip post-macrobiopsie sous guidage stéréotaxique et repérage préopératoire: trucs et astuces.

PURPOSE: Clip migration occurs frequently in clinical practice (13-20%), irrespective of the approach. The purpose of this article is to suggest tricks in order to decrease clip migration and optimize presurgical localization. MATERIALS AND METHODS: Retrospective study of breast macrobiopsy from a lateral approach performed between March 2003 and June 2004: 447 clips were placed. Sixty clips showed migration>20 mm, due to the accordion effect in 59 cases (98.4%). These 59 procedures were analyzed to try and understand the underlying mechanisms of clip migration. RESULTS: From these 59 clips, more migrations were noted on CC compression (16.6%) compared to MLO compression (5.2%). This difference was statistically significant. Therefore, we promote the use of MLO compression. This incidence also allows optimal presurgical localization in case of clip migration, by placing the patient in the same position while modulating depth based on the extent of clip displacement. CONCLUSION: For quality purposes, it is imperative to know the clip position relative to the initial target. By using MLO compression from a lateral approach, it is possible to reduce clip migration and optimize future presurgical localization.

[Role of MRI in the presurgical work-up of breast cancer: appropriate utilization of MRI as a complement to mammography and ultrasound]. / Place de l'IRM dans le bilan préchirurgical du cancer du sein: pour une utilisation raisonnée de cet examen complémentaire du bilan mammo-échographique.

The role of MRI for presurgical local staging of breast cancers amenable to conservative treatment has been the subject of multiple publications and tends to become a "validated" indication in routine practice. The purpose of the paper is to review the advantages and limitations of this imaging modality that is part of a comprehensive management that must be validated by clinical data especially with regards to local recurrence and survival. Knowledge of these elements combined with more precise indications should result in improved patient management while avoiding overtreatment or unnecessary anxiety-producing examinations.