[Elevation of PSA after prostate radiotherapy: rebound or biochemical recurrence?]. / Elévation du PSA après irradiation prostatique : rebond ou récidive biologique?

The fact that external beam radiotherapy and brachytherapy are now considered to be curative techniques has led to major review of the modalities of follow-up after radiotherapy for prostate cancer. The problem concerns both the diagnosis of recurrence, rapidly announced by elevation of prostatic-specific antigen (PSA), usually at a subclinical stage, and the validity of criteria of biochemical recurrence to allow comparison of various study. Physicians involved in follow-up should be aware of the potential of bounce in PSA follow-up after external beam radiotherapy or brachytherapy. The PSA bounce phenomemon was defined by a rise of PSA values (+0.1 -0.8 ng/ml) with a subsequent fall. Biochemical failure after external beam radiotherapy or brachytherapy (with or without hormonotherapy) was defined by Phoenix criteria by a rise of 2 ng/ml above an initial PSA nadir. This definition was more correlated to PSA bounce phenomenon.

[The STIR sequence. Comparison with other MRI sequences and scintigraphy in detecting spinal metastases]. / La séquence STIR. Comparison avec les autres séquences IRM et la scintigraphie dans le dépistage des métastases osseuses vertébrales.

A prospective MRI study of the spine comparing short inversion-recovery sequences (STIR)-one the features of which is to potentiate the contrast of both long T1 and T2 sequences-with other spin echo and/or gradient echo MRI sequences, was conducted in 20 patients with suspected vertebral metastases. The features of the signal on STIR sequences were initially defined in 14 healthy volunteers. In the patients, the various MRI sequences were also compared to each other and to standard x-rays and bone scans. The sensitivity of detection of vertebral metastases did not appear to be significantly different between T1 sequences and the STIR sequence. However, these two sequences appeared to be significantly more sensitive than T2-weighted sequences. The STIR sequences therefore appears to be a logical complement to T1-weighted sequences in the detection of vertebral secondaries. This sequence even appears to be superior in the following situations: investigation of the cervical vertebrae, follow-up of irradiated bone, early detection of periduritis and lesions of the posterior arch.

[Post-radiotherapy pericarditis. 5 cases (author's transl)]. / Péricardites post-radiques. 5 observations.

These cases represented 2.8% of the patients admitted for pericarditis during the same period. The cause of irradiation was a carcinoma of the breast in three cases and a carcinoma of the oesophagus in two cases. Acute forms of pericarditis occured 8 and 13 months after irradiations, and chronic forms after 1, 8 and 13 years. Three clinical forms were observed; two patients had an acute form; the first one with a slight effusion was easily cured, the second with cardiac tamponnade recovered after surgical evacuation, two others patients had a chronic latent effusion; after surgical evacuation, one recovered but the other one developped an occult constrictive pericarditis diagnosed by rapid volume expansion. The fifth case was a constrictive pericarditis which was effectively traited by pericardectomy. The difficulty of etiological diagnosis varies with the time and the amount of effusion. When the effusion is moderate the distinction must be made with an acute idiopathic pericarditis; when effusion is large the distinction must be made with a tuberculosis and specially a tumoral recurrence; in three cases pericardial biopsy was carried out and eliminated these diagnosises; lesions were similar: pericard was sclerous and little in cells, inflammatory signs were slight or absent. The postoperative prognosis in constrictive pericarditis may be agravated by associated myocardial lesions.