Publications of Paul MEUNIER
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See detailHepatic alveolar echinococcosis.
DETRY, Olivier ULiege; MEURISSE, Nicolas ULiege; Delwaide, Jean ULiege et al

in Acta Chirurgica Belgica (2018), 118(3), 200-201

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See detailAlveolar echinococcosis in southern Belgium: retrospective experience of a tertiary center.
Cambier, Audrey ULiege; LEONARD, Philippe ULiege; Losson, Bertrand ULiege et al

in European Journal of Clinical Microbiology and Infectious Diseases (2018), 37(6), 1195-1196

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See detailPrise en charge multidisciplinaire de l'echinococcose alveolaire : le groupe Echino-Liege.
Cambier, Audrey; GIOT, Jean-Baptiste ULiege; LEONARD, Philippe ULiege et al

in Revue Médicale de Liège (2018), 73(3), 135-142

Alveolar echinococcosis is a zoonotic disease due to the tapeworm Echinococcus multilocularis. The definitive host is the red fox. Until recently, Belgium was considered a country at very low risk for ... [more ▼]

Alveolar echinococcosis is a zoonotic disease due to the tapeworm Echinococcus multilocularis. The definitive host is the red fox. Until recently, Belgium was considered a country at very low risk for alveolar echinococcosis. However, recent studies carried out in southern Belgium have revealed, through post-mortem examination, high prevalences (up to 62 %) in foxes. Cats and dogs can act as definitive hosts. Human are accidentally infected by ingestion of food contaminated by the feces. After a long incubation period, invasive hepatic lesions may appear, as well as extra-hepatic lesions. The disease may be fatal. The diagnosis is based on imaging techniques, serology and nucleic acid detection in tissues. Early diagnosis may allow surgical removal of the lesion associated with at least 2 years of albendazole postoperative treatment. In case of contraindication to surgery, a long term treatment with albendazole is necessary. Liver transplantation is sometimes necessary. This article presents the epidemiologic, clinical, diagnostic and therapeutics features of this zoonotic disease. [less ▲]

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See detailAlveolar echinococcosis is now endemic in southern Belgium
Cambier, A; Leonard, Philippe ULiege; Losson, Bertrand ULiege et al

in Acta Gastro-Enterologica Belgica (2018, January), 81(1), 31

Introduction: Until now, Belgium has been considered as a low-risk country for alveolar echinococcosis (AE). However it was recently demonstrated by necropsy series that up to 51% of the red foxes (Vulpes ... [more ▼]

Introduction: Until now, Belgium has been considered as a low-risk country for alveolar echinococcosis (AE). However it was recently demonstrated by necropsy series that up to 51% of the red foxes (Vulpes vulpes) may be infected by E. multilocaris in some parts of Southern Belgium. The first local Belgian human AE cases were described in the early 2000's. Aim: The aim of this study was to report the experience of a tertiary university hospital of Southern Belgium with AE management. Methods: The authors retrospectively collected data from the parasitology laboratory (serologies), the hospital pharmacy in charge of supplying albendazole, and by searching through patient’s files with medico-economic information service of a tertiary university hospital. The medical files were retrospectively reviewed. Results: Twenty-one cases (66% male) of local AE have been recorded from 1999 to 2016. All patients were Belgian citizens with more than 30 years of life in Southern Belgium (Liege province: 10 cases (47.4%), Luxembourg province: 8 cases (36.8%), Namur Province: 3 cases (15.8 %)). Mean age of diagnosis was 66 years (ranges: (35-85y). Eighteen patients had hepatic involvement: 14 underwent surgical resection and 5 had unresectable liver lesions and underwent albendazole palliative therapy until death. During the same period, the faculty of veterinary medicine observed an increased rate of lethal hepatic AE in dogs, another indication of high AE incidence. Conclusions: AE appears to be spreading in Belgium and has actually an uneven geographical distribution with endemicity in areas of Southern and Eastern Belgium. However, it is probable that local AE cases will be diagnosed in the whole country, considering that there is no reason that infected foxes remain in Southern Belgium and also the fact that some people from Northern Belgium might spend long period in Southern Belgium, with or without their dogs. The liver is the most frequently involved organ and the only cure can be achieved by complete R0 resection of all AE lesions. In reaction to this experience, the authors created a multidisciplinary group for AE diagnosis and management, including hepatologists, infectiologists, microbiologists, pathologists, radiologists, nuclear medicine specialists, surgeons and veterinarians. The authorities should be aware of this medical issue and should facilitate the access to Albendazole for AE patients. A complete national survey should be encouraged, and BASL might have an important role in this study. [less ▲]

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See detail18-Fluoro-deoxyglucose uptake in inflammatory hepatic adenoma: A case report.
Liu, Willy; Delwaide, Jean ULiege; BLETARD, Noëlla ULiege et al

in World Journal of Hepatology (2017), 9(11), 562-566

Positron emission tomography computed tomography (PET-CT) using 18-Fluoro-deoxyglucose (18FDG) is an imaging modality that reflects cellular glucose metabolism. Most cancers show an uptake of 18FDG and ... [more ▼]

Positron emission tomography computed tomography (PET-CT) using 18-Fluoro-deoxyglucose (18FDG) is an imaging modality that reflects cellular glucose metabolism. Most cancers show an uptake of 18FDG and benign tumors do not usually behave in such a way. The authors report herein the case of a 38-year-old female patient with a past medical history of cervical intraepithelial neoplasia and pheochromocytoma, in whom a liver lesion had been detected with PET-CT. The tumor was laparoscopically resected and the diagnosis of inflammatory hepatic adenoma was confirmed. This is the first description of an inflammatory hepatic adenoma with an 18FDG up-take. [less ▲]

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See detailNon-invasive approaches in the diagnosis of acute rejection in kidney transplant recipients, part II: omics analyses of urine and blood samples
Erpicum, Pauline ULiege; HANSSEN, Oriane ULiege; WEEKERS, Laurent ULiege et al

in Clinical Kidney Journal (2017)

Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, the full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ... [more ▼]

Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, the full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ultimately relies on transplant needle biopsy. However, such an invasive procedure is associated with a significant risk of complications and is limited by sampling error and interobserver variability. In the present review, we summarize the current literature about non-invasive approaches for the diagnosis of AR in kidney transplant recipients (KTRs), including in vivo imaging, gene-expression profiling and omics analyses of blood and urine samples. Most imaging techniques, such as contrast-enhanced ultrasound and magnetic resonance, exploit the fact that blood flow is significantly lowered in case of AR-induced inflammation. In addition, AR-associated recruitment of activated leucocytes may be detectable by 18F-fluorodeoxyglucose positron emission tomography. In parallel, urine biomarkers, including CXCL9/CXCL10 or a three-gene signature of CD3ε, CXCL10 and 18S RNA levels, have been identified. None of these approaches has yet been adopted in the clinical follow-up of KTRs, but standardization of analysis procedures may help assess reproducibility and comparative diagnostic yield in large, prospective, multicentre trials. [less ▲]

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See detailNon-invasive approaches in the diagnosis of acute rejection in kidney transplant recipients. Part I. In vivo imaging methods.
HANSSEN, Oriane ULiege; Erpicum, Pauline ULiege; LOVINFOSSE, Pierre ULiege et al

in Clinical Kidney Journal (2017), 10(1), 97-105

Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ... [more ▼]

Kidney transplantation (KTx) represents the best available treatment for patients with end-stage renal disease. Still, full benefits of KTx are undermined by acute rejection (AR). The diagnosis of AR ultimately relies on transplant needle biopsy. However, such an invasive procedure is associated with a significant risk of complications and is limited by sampling error and interobserver variability. In the present review, we summarize the current literature about non-invasive approaches for the diagnosis of AR in kidney transplant recipients (KTRs), including in vivo imaging, gene expression profiling and omics analyses of blood and urine samples. Most imaging techniques, like contrast-enhanced ultrasound and magnetic resonance, exploit the fact that blood flow is significantly lowered in case of AR-induced inflammation. In addition, AR-associated recruitment of activated leukocytes may be detectable by 18F-fluoro-deoxy-glucose positron emission tomography. In parallel, urine biomarkers, including CXCL9/CXCL10 or a three-gene signature of CD3epsilon, IP-10 and 18S RNA levels, have been identified. None of these approaches has been adopted yet in the clinical follow-up of KTRs, but standardization of procedures may help assess reproducibility and compare diagnostic yields in large prospective multicentric trials. [less ▲]

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See detailComment j'explore ... la maladie de Crohn par imagerie.
DESIR, Colin ULiege; COIMBRA MARQUES, Carla ULiege; Decker, M. et al

in Revue Médicale de Liège (2017), 72(1), 51-56

Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between ... [more ▼]

Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between symptoms and intestinal lesions is weak. Therefore, monitoring by frequent cross-sectional imaging is proposed to assess the disease activity. There is no consensus about the preferred imaging option. Priority is given to non-radiating modalities, such as ultrasonography and MRI. Tomodensitometry will be reserved for emergency cases. Ultrasonography can be useful, in emergency as well as for the monitoring of lesions of known topography. Entero-MRI is henceforth considered the standard imaging technique for the diagnosis and follow-up of Crohn's disease. Its high contrast resolution allows an accurate assessment of disease activity, therapeutic efficacy, cumulative structural bowel damage and complications. [less ▲]

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See detailLA MALADIE DE CROHN STENOSANTE: Presentation clinique, diagnostic et modalites de traitement.
Bourseau, S.; Meunier, Paul ULiege; Coimbra, C. et al

in Revue Médicale de Liège (2016), 71(4), 178-83

Crohn's disease (CD) is a chronic inflammatory bowel disease which mainly affects young people. This disease evolves in successive steps and is often complicated by strictures which express characteristic ... [more ▼]

Crohn's disease (CD) is a chronic inflammatory bowel disease which mainly affects young people. This disease evolves in successive steps and is often complicated by strictures which express characteristic signs of occlusive syndrome, more often in case of ileal than colonic involvement. The nature and localisation of strictures should be precisely defined by different techniques like endoscopy, entero-(colo)-scanner or entero-(colo)-MRI. This work-up is essential to best adapt the therapeutic care. Indeed, the fibrosing evolution of inflammatory strictures causes medical treatment's failure which may lead to endoscopic dilatation or surgical resection. To avoid this negative evolution, it is mandatory to adopt early therapeutic strategy to control inflammation. [less ▲]

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See detailApport de l'échographie thoracique aux urgences : à propos d'un cas de dyspnée aiguë durant la grossesse
MARISSIAUX, Laurent ULiege; GENSBURGER, Mathieu ULiege; TROMBA, A et al

in Revue Médicale de Liège (2016), 71(7-8), 349-355

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See detailPrognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma.
Detry, Olivier ULiege; Govaerts, Laurence; De Roover, Arnaud ULiege et al

in World Journal of Gastroenterology (2015), 21(10), 3049-54

AIM: To evaluate the prognostic value of pretreatment FDG positron emission tomography computed tomography (PET-CT) in patients with hepatocarcinoma treated by liver transplantation (LT). METHODS: The ... [more ▼]

AIM: To evaluate the prognostic value of pretreatment FDG positron emission tomography computed tomography (PET-CT) in patients with hepatocarcinoma treated by liver transplantation (LT). METHODS: The authors retrospectively analyzed the data of 27 patients (mean age 58 +/- 9 years) who underwent FDG PET-CT before LT for hepatocarcinoma. Mean follow-up was 26 +/- 18 mo. The FDG PET/CT was performed according to a standard clinical protocol: 4 MBqFDG/kg body weight, uptake 60 min, low-dose non-enhanced CT. The authors measured the SUVmax and SUVmean of the tumor and the normal liver. The tumor/liver activity ratios (RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors: MILAN, CLIP, OKUDA, TNM stage, alphafoetoprotein level, portal thrombosis, size of the largest nodule, tumor differentiation, microvascular invasion, underlying cirrhosis and liver function. RESULTS: Overall and recurrence free survivals were 80.7% and 67.4% at 3 years, and 70.6% and 67.4% at 5 years, respectively. According to a multivariate Cox model, only FDG PET/CT RSUVmax predicted recurrence free survival. Even though the MILAN criteria alone were not predictive, it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax < 1.15 relapsed. CONCLUSION: FDG PET/CT with an RSUVmax cut-off value of 1.15 is a strong prognostic factor for recurrence and death in patients with HCC treated by LT in this retrospective series. Further prospective studies should test whether this metabolic index should be systematically included in the preoperative assessment. [less ▲]

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See detailDe l'"Evidence-based Medecine" à la médecine personnalisée dans la maladie de Crohn
Louis, Edouard ULiege; REENAERS, Catherine ULiege; VAN KEMSEKE, Catherine ULiege et al

in Revue Médicale de Liège (2015), 70(5-6), 316-320

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See detailPrognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma.
MEURISSE, Nicolas ULiege; DETRY, Olivier ULiege; Govaerts, L et al

in Transplant International (2014, September), 27(S2), 18-17

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See detailUtilisation de l'imagerie fonctionnelle en radiothérapie
LALLEMAND, François ULiege; LAKOSI, Ferenc ULiege; HUSTINX, Roland ULiege et al

in Revue Médicale de Liège (2014), 69(Supp 1), 20-28

Les progrès technologiques réalisés par l’image- rie médicale l’ont placée au centre de la prise en charge des patients oncologiques, tant au niveau du diagnostic, du pro - nostic et du suivi que dans la ... [more ▼]

Les progrès technologiques réalisés par l’image- rie médicale l’ont placée au centre de la prise en charge des patients oncologiques, tant au niveau du diagnostic, du pro - nostic et du suivi que dans la prise en charge thérapeutique. En effet, l’imagerie représente, à l’heure actuelle, la pierre angulaire des traitements de radiothérapie. Les objectifs du radiothérapeute sont d’irradier le plus précisément possible la tumeur à dose curative, tout en évitant les organes sains. Pour y arriver, le radiothérapeute utilise de façon routinière l’imagerie anatomique (Scanner et IRM). Depuis quelques années, le développement des différentes imageries métabo - liques et fonctionnelles, comme l’imagerie par émission de positons (PET-CT) et la résonnance magnétique fonctionnelle, ouvrent de nouvelles possibilités thérapeutiques grâce aux informations qu’elles apportent sur la biologie des tumeurs. Cet article décrit, de manière non exhaustive, les différentes imageries anatomiques et métaboliques à la disposition du radiothérapeute. [less ▲]

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See detailQuinze ans d'anti-TNF dans la maladie de Crohn: comment tirer le meilleur de cette revolution therapeutique?
Louis, Edouard ULiege; REENAERS, Catherine ULiege; Meuwis, Marie-Alice ULiege et al

in Revue Médicale de Liège (2012), 67 Spec No

After fifteen years of use, the anti-TNF antibodies have become the corner stone of the treatment of moderate and severe Crohn's disease. The skill acquired over the years through experimental trials and ... [more ▼]

After fifteen years of use, the anti-TNF antibodies have become the corner stone of the treatment of moderate and severe Crohn's disease. The skill acquired over the years through experimental trials and clinical experience leads to increased therapeutic efficacy and minimized risks. These antibodies are introduced increasingly earlier in Crohn's disease as well as in a broader range of patients, aiming at changing the natural history of the diseases by avoiding the development of intestinal tissue damage and complications. [less ▲]

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See detailRuptured hepatocellular carcinoma following transcatheter arterial chemoembolization.
BRULS, Samuel ULiege; JOSKIN, Julien ULiege; Chauveau, Raphaël ULiege et al

in JBR-BTR (2011), 94(2), 68-70

Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment in unresectable hepatocellular carcinoma (HCC). Although TACE can control tumour growth and palliate the ... [more ▼]

Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment in unresectable hepatocellular carcinoma (HCC). Although TACE can control tumour growth and palliate the patients, complications of TACE with significant morbidity are well known and adversely affect the outcome of patients. Necrotic tumor rupture is a serious complication of TACE and has a high mortality rate. We report a case of ruptured HCC following TACE in a 78-year-old male patient who subsequently developed peritonitis and pneumoperitoneum. This case gives us the opportunity to underline the importance of such complications and demonstrates the utility of CT imaging for diagnosis and management of patients with ruptured HCC. [less ▲]

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See detailL’image du mois. Localisation rénale d’un lymphome
Dispas, Hélène; Delperdange, Mélanie; Meunier, Paul ULiege et al

in Revue Médicale de Liège (2010), 65(7-8), 427-429

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See detailLe cas clinique du mois. Le lymphangiome kystique du mesentere
Verdin, Vanessa ULiege; Seydel, Benoît ULiege; Detry, Olivier ULiege et al

in Revue Médicale de Liège (2010), 65(11), 615-8

Cystic lymphangioma of the mesentery is a benign condition, probably of malformative origin, and frequently appearing in infancy. Its symptomatology can be very polymorphic. Its diagnosis is suspected by ... [more ▼]

Cystic lymphangioma of the mesentery is a benign condition, probably of malformative origin, and frequently appearing in infancy. Its symptomatology can be very polymorphic. Its diagnosis is suspected by ultrasonography and computed tomography, and definitely confirmed by pathology. About a recent case of cystic lymphangioma of the mesentery diagnosed and operated on at the university hospital of Liege in an adult patient, the authors review its classification and its therapeutic strategy. Surgical resection is indicated in symptomatic cystic lymphangioma. [less ▲]

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See detailL’étude du mois. Traitement de l’hépatocarcinome au stade palliatif par Sorafenib (Nexavar) :Résultats de l’étude SHARP (Sorafenib Hepatocarcinoma Assessment Randomized Protocol)
Detry, Olivier ULiege; Delwaide, Jean ULiege; Deroover, Arnaud ULiege et al

in Revue Médicale de Liège (2009), 64(3), 168-170

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no ... [more ▼]

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no efficient therapeutic mean was available for advanced hepatocarcinoma. Sorafenib is a multikinase inhibitor that decreases tumoral proliferation and angiogenesis, and increases apoptosis in many cancer models. The results of a phase 3 randomized, multicentric, study, entitled SHARP, have now demonstrated that Sorafenib increases survival in patients with advanced hepatocarcinoma developed in Child A cirrhosis. Mean survival gain was a little less than 3 months, without any radiologic response or improvement in the delay before symptomatic progression of the disease. The monthly cost of Sorafenib is a little more than 5,000 euros. It is now crucial to evaluate the potential role of Sorafenib in adjuvant therapy after liver resection or radiofrequency ablation of hepatocarcinoma. The CHU of Liège is taking part to a randomized, multicentric study evaluating the use of Sorafenib after liver resection or radiofrequency ablation for hepatocarcinoma. Another future evaluation could be the association of Sorafenib with other antitumoral agents. [less ▲]

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See detailL'appendagite epiploique. Un diagnostic meconnu.
Jobe, Jérôme ULiege; Ghuysen, Alexandre ULiege; Meunier, Paul ULiege et al

in Revue Médicale de Liège (2009), 64(7-8), 382-5

Epiploic appendagitis is the term used to describe the inflammation of an epiploic appendage. These small masses of fat distributed along the colon, from the caecum to the recto-sigmoid junction can ... [more ▼]

Epiploic appendagitis is the term used to describe the inflammation of an epiploic appendage. These small masses of fat distributed along the colon, from the caecum to the recto-sigmoid junction can inflammate by torsion, spontaneously or secondarily with the inflammation of an anatomical structure in the neighbourhood. Symptomatology may mimic retro-caecal appendicitis or diverticulitis and the diagnosis by CT avoids unnecessary surgery or hospitalization. Indeed, under conservative treatment by AINS and analgesics, symptomatology regresses in about five days. In this article, we relate the case of a patient with a typical clinical presentation, to remind the elements of this pathological entity. [less ▲]

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