[Contribution of a new technique of digital enhancement for the control of radiation fields]. / Apport d'une nouvelle technique de numérisation au contrôle des champs d'irradiation.

To increase geometric treatment accuracy in radiation therapy, we used a novel digitized method and original image processing. The radiographic films that are conventionally used for verifying each beam during the treatment were digitized by a Kodak digital system and then an original image enhancement was applied. For the evaluation of our technique, a clinical trial with two tests was used. The trial involved four readers doing 80 reading. The enhanced films were judged to be of higher quality than the non enhanced films (p = 0.001) and were read more accurately (p < or = 0.001). This automatic enhancement of digitized captured portal images can be easily integrated into the busy routine of a radiotherapy department.

Biodistribution study of 99mTc-labeled LDL in B16-melanoma-bearing mice. Visualization of a preferential uptake by the tumor.

Since there is strong evidence of a preferential LDL accumulation in tumor cells, LDL might be of interest for tumor imaging. We have tested the ability of 99mTc-LDL in tumor imaging with B16-melanoma-bearing mice as a model for further applications in human studies. The LDL fixation rate was higher with 99mTc-labeled LDL than with 125I labeled LDL. Since technetium-99m remains trapped in the cells, 99mTc-LDL is a well-adapted radioligand because of information given by this radiotracer on the receptor metabolism. We observed that, at early growth stages, the tumor took up the LDL at a maximal rate, suggesting differences in cholesterol metabolism as a function of tumor growth. Accumulation of label in the tumor area was perfectly observable in tumor-bearing mice on scintigraphic images. Computerized quantification of the regions of interest (as well as biodistribution studies including killing of the animals) showed a 1.81-fold increase in uptake by the tumor as compared to the liver and a 28-fold increase as compared with corresponding normal tissue (muscle of the left leg) at day 8 of tumor growth. These data give strong support to the value of this non-invasive method in visualizing and quantifying the tissue LDL uptake in vivo, including the precise information provided by nuclear scintigraphy on the distribution of the radiolabeled LDL in the different tissues. 99mTc-LDL could be an efficient tool for further diagnostic or therapeutic exploration in cancer patients.

Anatomic changes in the abdominal cavity during intraperitoneal chemotherapy: prospective study using scintigraphic peritoneography.

Twenty-one patients undergoing either adjuvant or palliative intraperitoneal (ip) chemotherapy had repeated scintigraphic peritoneographies. Significant scintigraphic ip changes were recorded in 11 patients (52%). In patients without residual disease at the time of ip chemotherapy, the rate of ip mal-distribution reached 70%. These alterations did not correlate with clinical complications. Our study suggested that, independently of clinical assessment, scintigraphic peritoneography is a useful test for identifying patients who are no longer suitable for ip treatment, due to inadequate locoregional distribution.

[Multiple localization and lymphatic involvement of papillary micro-carcinoma of the thyroid. Results of total thyroidectomy with bilateral lymph node excision. Apropos of 38 patients]. / Multifocalité et lymphophilie des micro-carcinomes papillaires thyroidiens. Résultats de la thyroïdectomie totale avec évidement bilatéral, à propos de 38 patients.

This study involved 38 patients with occult papillary carcinoma of the thyroid gland treated by total thyroidectomy and bilateral prophylactic neck dissection. The histological results show the glandular multicentricity on either side, both in single nodule (65%) and in multinodular goiter (73.3%). High risk of cervical spreading clearly appears in papillary carcinoma (18.4% of the patients) even in these small foci (lower than 10 mm). Topography of involvement brings into prominence two main territories: paratracheal, mid and lower jugularly nodes (involved in 92.8% of the positive dissections).

[Thyroid trabecular carcinoma. A clinicopathological entity of poor prognosis? (author's transl)]. / L'epithélioma trabéculaire du corps thyroïde. Une entité anatomoclinique à pronostic défavorable?

The records of 32 patients with trabecular carcinomas of the thyroid gland were critically reviewed from a previously published serie of 138 thyroid cancers referred to the Centre Claudius Regaud, between 1952 and 1973. On the basis of clinico-pathological considerations, it seems possible to divide trabecular carcinomas into two groups. Pure trabecular carcinomas (moderately differenciated follicular carcinomas--WOH) which have a poor prognosis (5 years actuarial survival: 13%) related to high rate of local recurrences, fast metastatic spread to the lung, bad response to suppressive hormonotherapy and lack of 131 iode uptake by malignant tissue. Mixed trabeculo-vesicular carcinomas which have in comparison a fairly good prognosis (5 years actuarial survival: 63%) in keeping with a lower tendency to local recurrences and a useful concentration of radioactive iodine by metastases (most of them located in the skeleton) although dependent on the pourcentage of vesicles in the tumor process. Among differentiated thyroid carcinomas, distinction between pure trabecular and mixed trabeculo-vesicular carcinomas with quantitative determination of vesicules seems of great interest in relation to the therapeutic approach.

[Thyroid carcinomas. Critical study about 138 observations. Therapeutic deductions (author's transl)]. / Cancers thyroïdiens. Etude critique de 138 observations. Déductions thérapeutiques.

Between 1952 and 1973, 138 patients with thyroïd carcinoma have been recorded. From the critical study of these cases, the pathological, etiological and clinical features have been studied. Different therapeutic modalities are evaluated from these cases. Surgery was always used when possible. A hemithyroïdectomy was realised most often. We stress that sterilisation was obtained by 131I treatment in plurifocal metastasis, particularly in pulmonary metastasis, only when the iodine uptake was sufficient. Survival has been evaluated according to the pathology: papillary and vesicular carcinomas have a good prognosis (the papillary and vesicular survival rate at 10 years reaches respectively: 65% and 64%). Anaplastic carcinomas have a bad prognosis (the survival rate at 5 years is 18%, at 10 years, 0%. These results are similar to those published by differents authors. At the opposite, trabecular carcinomas have a very short survival (8% at 5 years, 7% at 10 years) which is very unusual in well differentiated thyroïd carcinomas. It has to be isolated from the others.

[The half-life of iodine 131-labelled fibrinogen in cancer patients. Effects of heparin]. / Demi-vie du fibrinogène marqué à l'iode 131 chez les cancéreux. Effets de l'héparine

Sixty nine patients suffering from malignant tumours at different stages of their development underwent a kinetic study of fibrinogen 131I with external counting over the tumour and a study of haemostasis including P.D.F. The 1/2 T of fibrinogen 131I is shortened: 2.52 +/- 0.09 days (normal: 3.89 +/- 0.11 days.) The abnormality is proportional to serum P.D.F. levels (r=0.99). External counting demonstrated the uptake of labelled fibrinogen in the tumour. Heparine (15000 U/24h) restores the 1/2 T of fibrinogen to normal in 95 p. cent of cases. The results suggest the existence of a localised compensated intravascular coagulation process inside the tumour. Possible consequences of that phenomenon are discussed.

[Contribution to the scintigraphic diagnosis of malignant endothoracic tumors by 57Co labeled Bleomycin (author's transl)]. / Apport de la bléomycine marquée par le cobalt 57 dans le diagnostic scintigraphique des tumeurs malignes endothoraciques

The authors report the results of the exploration by 57Co Bleomycin scinitigraphy in 97 thoracic tumors. The Bleo-57Co scintigraphy detects primary and secondary malignant tumors underevaluated by classical tests. In the thorax, the radioactive focus are easily detected on account of the light physiological fixation of the Bleo-57Co. It is particularly interesting in the mediastinal tumors where the picture is not covered by cardiovascular interference. Mediastinal, pleural and costal tumors have been explored. Pulmonary tumors give the best results, they fixe in 93% of the case. All the mediastinal tumors have capted the bleomycin but the authors insist on the fact that the fixation was very light even when the tumor was a large one. The exploration of pleural and costal tumors was less interesting. In conclusion, the Bleo-57Co scintigraphy, gives indications about the volume of the tumor and its spread in the organism. By this method, we can diagnose malignancy in tumor. It can be used to survey cancer patients which have been treated. Nevertheless the long half-life (270 days) and the lack of specificity of the Bleo-57Co for the malignant tumors, justify discussion about indications and the results of such an exploration.