References of "COUCKE, Philippe"
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See detailLa médecine du futur. Poser un diagnostic: avez-vous du flair?
COUCKE, Philippe ULiege

in Revue Médicale de Liège (2019)

Since centuries, the human clinical observation skills include our capacity to smell. However, it is well known that this particular capacity is largely outraced by our lovely dogs. Some centers around ... [more ▼]

Since centuries, the human clinical observation skills include our capacity to smell. However, it is well known that this particular capacity is largely outraced by our lovely dogs. Some centers around the world are actively training these dogs in order to provide a correct diagnosis for particular diseases. This clinical observation has given rise to intensive development of digital tools which are able to recognize patterns of volatile organic compounds (VOC’s) in the exhaled air, but not only. It is not a single VOC which is important but an association - a specific pattern - which at the end represents the signature of a disease. This opens the door widely to applications both in the diagnostic field, as well as for follow-up of treated patients. [less ▲]

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See detailLa médecine du futur. Laennec contre Forbes : match nul ! Comment la technologie nous aide à interpréter l’auscultation
Coucke, Philippe ULiege

in Revue Médicale de Liège (2019), 74

For at least two centuries, the stethoscope has served as an essential cornerstone in clinical semiology. The sounds of heart and lung have been used for the differential diagnosis by multiple generations ... [more ▼]

For at least two centuries, the stethoscope has served as an essential cornerstone in clinical semiology. The sounds of heart and lung have been used for the differential diagnosis by multiple generations of physicians. One can argue today that our hearing and cognitive capacities are largely outraced by the development of new techniques with embarked artificial intelligence. This latter is able to recognize and differentiate with high precision cardiac and pulmonary sounds. [less ▲]

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See detailVirtual reality: A tool in the treatment of anxiety in stereotaxic radiotherapy?
Gamin, Nicolas ULiege; JANSEN, Nicolas ULiege; COUCKE, Philippe ULiege et al

Poster (2019, May 14)

Stereotaxic radiotherapy (SR) is an effective treatment for many types ofcancer but seems to cause anxiety. The purpose of this study is to determine whether experiencing the medical procedure by using ... [more ▼]

Stereotaxic radiotherapy (SR) is an effective treatment for many types ofcancer but seems to cause anxiety. The purpose of this study is to determine whether experiencing the medical procedure by using immersive virtual video can reduce preoperative anxiety. The experimental group (n=10) received information about the intervention and was exposed three times to the procedure before the SR. Two immersions took place in the days precedingthe intervention and the third took place just before the SR. The control group (n=10) only received information about the intervention. The STAI Y-A scale was used to measure state anxiety before and after each virtual immersion in the experimental group and just before and after the SR in both groups. We observed a similar decrease in anxiety across groups, which did not differ between them. Despite this result, it is important to point out that the experimental group reported a significant decrease in anxiety after the two immersions of day 1. The third immersion was not accompanied by a decrease of it. In conclusion, virtual reality seems useful in the treatment of preoperative anxiety, but its use is not enough to neutralize patient’s anxiety when approaching treatment [less ▲]

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See detailThe status of radiation oncology (RO) teaching to medical students in Europe
BEN MUSTAPHA, Selma ULiege; Meijnders, paul; COUCKE, Philippe ULiege et al

in Clinical and Translational Radiation Oncology (2019)

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See detailLe débat se crispe autour de CRISPR! Ne jetons pas le bébé avec l'eau du bain...
COUCKE, Philippe ULiege

in Onco: Revue Multidisciplinaire d'Oncologie (2019), 13

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See detailMoyens numériques pour améliorer l'adhésion au traitement oral
Coucke, Philippe ULiege

in Onco: Revue Multidisciplinaire d'Oncologie (2019), 13

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See detailTumor modifications recorded with IVIM and DCE-MRI after Neoadjuvant radiotherapy.
LALLEMAND, François ULiege; LEROI, Natacha ULiege; Bahri, Mohamed Ali ULiege et al

in Radiotherapy and Oncology (2019, April), 133(Supplement 1), 284-285

Purpose or Objective Neoadjuvant radiotherapy (NeoRT) improves tumor local control and facilitates tumor resection in many cancers. We hypothesized anti-cancer treatments (i.e. radiotherapy) modify tumor ... [more ▼]

Purpose or Objective Neoadjuvant radiotherapy (NeoRT) improves tumor local control and facilitates tumor resection in many cancers. We hypothesized anti-cancer treatments (i.e. radiotherapy) modify tumor microenvironment and could potentially impact distant metastases occurrence. Previously, we developed a pre-clinical model demonstrating an impact of NeoRT schedule and the timing of surgery on metastatic spreading (Leroi et al. Oncotarget 2015). Here, we aim to identify by fMRI noninvasive markers reflecting NeoRT related tumor microenvironment modifications that could predict the best timing for performing surgery and avoiding tumor spreading. Material and Methods To briefly delineate the NeoRT model, MDA-MB 231 tumor cells implanted in the flank of SCID mice were locally irradiated with 2x5Gy when tumor reached 100mm3 and then surgically removed at different time points. We performed fMRI, Diffusion Weighted (DW) and Dynamic Contract enhancement (DCE) – MRI, before RT and every 2 days between RT and surgery. We acquired 8 slices of 1 mm thickness and 0.5 mm gap with an “in plane voxel resolution” of 0.5 mm. For DW-MRI, we performed FSEMS (Fast Spin Echo MultiSlice) sequences, with 9 different Bvalue (from 40 to 1000) and B0. We performed IVIM (IntraVoxel Incoherent Motion) analysis to obtain information on intravascular diffusion, related to perfusion (F: perfusion factor) and subsequently tumor vessels perfusion. For DCE-MRI, we performed a T1 mapping with multiple TR and DCE acquisition with 200 repetitions of 3 sec each and gadolinium IV injection after 10 repetitions. We performed semi-quantitative analysis. We validated tumor perfusion by immunochemistry with injection of FITC-dextran IV 3 min before surgery and CD31 labelling. Human Ki67 was used for lung metastases labelling and quantification. Results After the tumor irradiation, we observed a significant and transient increase at day 6 (60% of the basal value (n=6, p<0,05)) of F and D* parameters related to perfusion. The other parameters of the DW-MRI, ADC and D presented no modifications. The sham irradiated tumors used as control showed no modifications of all fMRI parameters. At the same timing, 6 days post-radiotherapy, DCE-MRI significantly demonstrated a WhashinSlope (n=13, p<0,05) increase. Immunochemistry confirmed the increase of tumor perfusion when surgery is performed at day 6. The sham irradiated tumors never demonstrated such changes. Finally, when surgery is performed on tumor increased perfusion measured by fMRI, it demonstrated a burst of lung metastasis compared to the other timings. Conclusion We showed a significant difference in perfusion-related parameters with fMRI and immunochemistry at a specific time point after NeoRT. These modifications are correlated with an increase of metastasis spreading related to surgery procedure. These results open new perspectives in the personalized medicine and MRI guided surgery timing after NeoRT. [less ▲]

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See detailLa medecine du futur. Le lifting indispensable du dossier medical personnalise et informatise.
Coucke, Philippe ULiege

in Revue Médicale de Liège (2019), 74(2), 104-110

A revised Electronic Health Record (HER) is one of the most important keystones for the building of a new ecosystem. The latter is characterized by keywords such as big data, artificial intelligence, and ... [more ▼]

A revised Electronic Health Record (HER) is one of the most important keystones for the building of a new ecosystem. The latter is characterized by keywords such as big data, artificial intelligence, and cloud technology. The HER, which is used nowadays, does not fit within this purpose and - by the way - is considered as one of the most important reasons for frustration and burnout in the medical profession. Very often, the HER is mainly designed to collect data useful for billing purposes. However, it has to evolve rapidly to a tool which allows both storage of controlled and validated data, and analysis resulting in useful information. This information can help the professional both in diagnosis and prevention, at an individual level as well as at the level of population health. It should also be of potential use for organization and management of the health care sector as a whole. This deep facelift is an absolute requirement, if we want to cope with the major challenges of our exhausted health care sector. [less ▲]

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See detailLa medecine du futur. L'impression 3D en sante (2eme partie) : les organes a fonction vitale.
Coucke, Philippe ULiege; Lancellotti, Patrizio ULiege

in Revue medicale de Liege (2019), 74(4), 218-225

In a previous article, we highlighted the technical characteristics and economical advantages of additive manufacturing, especially for medical material as well as "hard" body structures without vital ... [more ▼]

In a previous article, we highlighted the technical characteristics and economical advantages of additive manufacturing, especially for medical material as well as "hard" body structures without vital function (bone, cartilage and teeth). In the present paper we illustrate the technological advances in the field of printing vital organs. From a simple idea to a proof of concept, steps will be taken rapidly in order to introduce these techniques for functional replacement in the clinics in order to solve the ever-growing gap between supply and demand in the field of organ transplantation. [less ▲]

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See detailExercise and Education Program After Breast Cancer: Benefits on Quality of Life and Symptoms at 3, 6, 12, and 24 Months' Follow-up
LECLERC, Anne-France ULiege; Slomian, Justine ULiege; JERUSALEM, Guy ULiege et al

in Clinical Breast Cancer (2018), 18(5), 1189-1204

BACKGROUND: Various clinical trials show benefits of physical training offered during and / or after breast cancer treatments. However, given the variety of side effects that may be encountered, physical ... [more ▼]

BACKGROUND: Various clinical trials show benefits of physical training offered during and / or after breast cancer treatments. However, given the variety of side effects that may be encountered, physical training could be combined with psychological, relational and social guidance. This kind of multidisciplinary program, just like their long-term effects, have been little studied so far. Therefore, the objective of our study is to determine the benefits at 3, 6, 12 and 24 months of a three-month exercise and education program among women after breast cancer treatment. MATERIALS AND METHODS: Two hundred and nine outpatients who have been treated for a primary breast carcinoma were divided into a control group (n=106) and an experimental group (n=103) which has benefited from a three-month rehabilitation program including physical training and psycho-educational sessions. The assessments, performed before the program and at 3, 6, 12 and 24 months after inclusion, included validated questionnaires on quality of life and symptoms. RESULTS: The analyses show an improvement in quality of life and symptoms following the exercise and education program within the experimental group and a maintenance of these improvements during the two years of follow-up. These improvements are significantly superior to those presented in the control group, demonstrating the programs benefits. CONCLUSIONS: This trial identifies the benefits of a well detailed three-month exercise and education program over a follow-up of 24 months among women after breast cancer treatment. [less ▲]

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See detailTumor microenvironment modifications recorded with IVIM perfusion analysis after radiotherapy.
LALLEMAND, François ULiege; LEROI, Natacha ULiege; Bahri, Mohamed Ali ULiege et al

in Radiotherapy and Oncology (2018, April), 127(Supplement 1), 1285-1286

Purpose or Objective Neoadjuvant radiotherapy (NeoRT) improves tumor local control and facilitates tumor resection in many cancers. The timing between the end of the NeoRT and surgery is driven by the ... [more ▼]

Purpose or Objective Neoadjuvant radiotherapy (NeoRT) improves tumor local control and facilitates tumor resection in many cancers. The timing between the end of the NeoRT and surgery is driven by the occurrence of side effects or the tumor downsizing. Some clinical studies demonstrated that the timing of surgery and the RT schedule influence tumor dissemination and subsequently patient overall survival (Acta Oncol 2006). Previously, we developed a pre-clinical model demonstrating an impact of NeoRT schedule and the timing of surgery on metastatic spreading (Oncotarget 2015). Here, we used functional MRI (fMRI) to record tumor microenvironment modifications after NeoRT. We aim to get non-invasive markers to establish the best timing to perform surgery and avoiding tumor spreading. Material and Methods Based on our NeoRT model, MDA-MB 231 and 4T1 cells were implanted in the flank of SCID and BalbC mice, respectively. We locally irradiated (PXI, X-Rad SmART) tumors with 2x5Gy and then surgically removed at different time points after RT. We acquired fMRI (9,4T Agilent) before and after RT. Diffusion Weighted (DW) - MRI was performed every 2 days between RT and surgery. For each tumor, we acquired 8 slices of 1 mm thickness and 0.5 mm gap with an "in plane voxel resolution” of 0.5 mm. For DW-MRI, we performed FSEMS (Fast Spin Echo MultiSlice) sequences, with 9 different B-value (from 40 to 1000) and B0, in the 3 main directions. We performed IVIM (IntraVoxel Incoherent Motion) analysis to obtain information on intravascular diffusion, related to perfusion (F: perfusion factor) and subsequently tumor vessels perfusion. Results With the MDA-MB 231, we observed a significant and transient increase (60% of the basal value (n=6, p<0,05)) of F and D* parameters related to perfusion. The other parameters of the DW-MRI, ADC and D presented no modification. We observed similar results with 4T1 cells, where F increased at day 3 (55% of the basal value, n=10, p<0,05) then returned to initial level. The difference in timing for the peak of F (day 6 vs day 3) could be related to the difference in tumor growth according to the cell line (four weeks for MDA-MB 231 cells vs one week for 4T1 cells). We also observed a decrease of hypoxia (pimonidazole staining) when surgery was performed on the peak but vascular architecture was not affected. Moreover, performing surgery during F and D* peak, in the MDA-MB 231model, is associated with an increase of lung metastases: 115% and 187% compared to a surgery performed before or after the peak. Conclusion We demonstrated the feasibility of repetitive fMRI imaging in preclinical models after NeoRT. We showed a significant difference in perfusion-related parameters (D* and F) at a specific time point depending of tumor cells correlated with tumor metastases. We demonstrated the feasibility of Image Guided Surgery for decreasing tumor metastases after NeoRT. [less ▲]

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See detailBrain modifications after stereotactic radiotherapy recorded by Functional MRI.
LALLEMAND, François ULiege; LEROI, Natacha ULiege; Bahri, Mohamed Ali ULiege et al

in Radiotherapy and Oncology (2018, April), 127(Supplement 1), 582

Purpose or Objective Brain irradiation is commonly used in malignant diseases (i.e. metastases or Glioblastoma) and in benign diseases (i.e. meningioma, epilepsy, vestibular schwannoma or Parkinson ... [more ▼]

Purpose or Objective Brain irradiation is commonly used in malignant diseases (i.e. metastases or Glioblastoma) and in benign diseases (i.e. meningioma, epilepsy, vestibular schwannoma or Parkinson disease). The use of stereotactic radiosurgery (SRS) allows the administration of very high doses in a single fraction (e.g. 120Gy), in a small brain volume. After irradiation, morphological and functional cerebral changes occur depending on the total dose, dose per fraction and the irradiated brain volume. The aim of this work is to use f-MRI to record adult normal brain tissue modification after irradiation with different radiotherapy doses and schedules and to identify new parameters of brain radio-damages. Material and Methods With a dedicated small animal radiotherapy device allowing IGRT (PXI, X-Rad SmART), we specifically irradiated with a 2mm-collimator, mimicking SRS, a small part of adult brain mice (n=72), known to have no impact on vital function, with dose schedules: 1X20Gy, 3X10Gy, 4X5Gy and no RT as control. We imaged brain mice longitudinally with a dedicated 9.4-T MRI (Agilent). Imaging was realized once before as reference level and after irradiation every month for the first 6 months and every 3 months during one year. For each mouse we acquired 14 slices of 1 mm thickness and 0.5 mm gap with an “in plane voxel resolution” of 0.5 mm. We performed T1-weighted, T2-weighted, T1-mapping, T2-mapping and DW-MRI. For DW-MRI, we performed Fast Spin Echo MultiSlice sequences, with 9 different B-value and B0 (from 20 to 1000). We performed IntraVoxel Incoherent Motion (IVIM) analysis to obtain information on intravascular diffusion, related to perfusion (F: perfusion factor). Results Only mice irradiated with 120Gy showed brain modifications in T1 and T2 anatomic images and in T1 mapping, ADC, D and F but no changes were recorded in D* or T2 mapping. All these changes started 5 weeks after SRS and then stabilized after 7 weeks. The mean values for the control group were stable during the 5 months (ADC 0,73μm²/ms; D 0,66μm²/ms; F 4,67%, T1 1,25 sec). For the 120Gy group, values were significantly higher after 5 weeks (Δ = compared to the control group) with ADC 1,66μm²/ms (Δ=151%); D 1,37μm²/ms (Δ=107%); F 18,84% (Δ=303%); T1 1,99 sec (Δ=59%). No specific behaviour changes were observed during all the experiment. Conclusion In this work, we studied normal brain modifications after SRS therapy with anatomical and functional MRI. SRS doses and schedules in this work reflected those used in clinic for tumor treatment or functional SRS. We showed an increase of ADC value 5 weeks after one single dose of 120Gy, compared to normal brain tissue. These results are consistent with radio-necrosis. In addition, we highlighted an increase of IVIM parameters D and F and an increase of T1 mapping in radio-necrosis area. These results increase the numbers of MRI parameters that could be used for following brain damage after radiation. [less ▲]

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See detailA simple clinical method for predicting the benefit of prone vs. supine positioning in reducing heart exposure during left breast radiotherapy
Kahan; Rarosi, Ferenc; Gaal, Szilvia et al

in Radiotherapy and Oncology (2018)

Background and purpose: The benefit of reduced radiation heart exposure in the prone vs. supine position individually differs. In this prospective cohort study, the goal was to develop a simple method for ... [more ▼]

Background and purpose: The benefit of reduced radiation heart exposure in the prone vs. supine position individually differs. In this prospective cohort study, the goal was to develop a simple method for the operation of a validated model for the prediction of preferable treatment position during left breast radiotherapy. Material and methods: In 100 cases, a single CT slice was utilized for the collection of the needed patientspecific data (in addition to body mass index, the distance of the LAD from the chest wall and the area of the heart included in the radiation fields at the middle of the heart in the supine position). Outcome was analyzed in relation to the full CT series acquired in both positions and dosimetric data. Results: Great consistency was found between the tested and original method regarding sensitivity and specificity. The prioritization of LAD dose, and the use of heart dose and position-specific dose constraints as safety measures ensure sensitivity and specificity values of 82.8% and 87.3%, respectively. In an additional ‘‘routine clinical practice” series of 60 patients the new method seemed feasible in routine clinical practice. External testing on a 28-case series indicated similar accuracy. Conclusion: We consider this simple clinical tool appropriate for assisting individual positioning aiming at maximum heart protection during left breast irradiation [less ▲]

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See detailI have a dream… Et si nous rêvions de nouvelles approches en oncologie?
COUCKE, Philippe ULiege

in Onco: Revue Multidisciplinaire d'Oncologie (2018), 12(3), 3

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See detailNecessite d'un nouvel ecosysteme en sante... Tous les elements sont deja disponibles.
Coucke, Philippe ULiege; Coucke-Gilson, L.

in Revue Médicale de Liège (2018), 73(9), 454-461

The key performance indicators in healthcare illustrate that the system we run nowadays is no longer sustainable. There is an urgent need for fundamental changes within the current ecosystem, if we want ... [more ▼]

The key performance indicators in healthcare illustrate that the system we run nowadays is no longer sustainable. There is an urgent need for fundamental changes within the current ecosystem, if we want to maintain or improve the levels of quality, security and equity in healthcare. Disruptive technologies profoundly modify all domains of our society. Those changes, driven by technical convergence, are particularly rapid and extensive in the fields such as big data and analysis, artificial intelligence, cloud and blockchain. These continuously evolving technologies could potentially offer opportunities to efficient problem solving in the health care sector. The culture of our organizations needs major changes and especially adaptability and fast speed integration to a process which is inevitable. [less ▲]

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See detailNHL-ChirEx: An interprofessional cross-border education initiative in the Greater Region with a focus on radiation morbidity and patient safety
Vogin, Guillaume; Fleckenstein, Jochen; Servotte, Jean-Christophe ULiege et al

in Radiotherapy and Oncology (2018)

NHL-ChirEx is an interprofessional cross-border education initiative that addresses the potential excess of radiation induced morbidity.

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See detailPeut-on considérer que la radiothérapie agit en dehors du site irradié ? L'effet abscopal.
Pleyers, C.; Piret, P.; RORIVE, Andrée ULiege et al

in Revue Médicale de Liège (2018), 73(1), 17-21

Radiotherapy is known for its action on local tumoral control. However, it is also able to induce immunomodulatory effects at a systemic level. The abscopal effect (from latin ab scopus which means <<away ... [more ▼]

Radiotherapy is known for its action on local tumoral control. However, it is also able to induce immunomodulatory effects at a systemic level. The abscopal effect (from latin ab scopus which means <<away from the target>>) is an illustration of this phenomenon. It is defined as a tumor regression observed outside and at a distance of the irradiation fields. The potential application of this effect of treatment in disseminated cancers is a fast-growing field of research. The optimal therapeutic strategy to achieve this effect remains unknown. [less ▲]

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