Publications of Laurent GERARD
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See detailPreoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis.
Heil, J.; Korenblik, R.; Heid, F. et al

in British Journal of Surgery (2021)

BACKGROUND: The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE ... [more ▼]

BACKGROUND: The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability. METHODS: All centres of the international DRAGON trials study collaborative were asked to provide data on patients who had PVE/HVE or PVE on 2016-2019 (more than 5 PVE/HVE procedures was a requirement). Liver volumetry was performed using OsiriX MD software. Multivariable analysis was performed for the endpoints of resectability rate, FLR hypertrophy and major complications using receiver operating characteristic (ROC) statistics, regression, and Kaplan-Meier analysis. RESULTS: In total, 39 patients had undergone PVE/HVE and 160 had PVE alone. The PVE/HVE group had better hypertrophy than the PVE group (59 versus 48 per cent respectively; P = 0.020) and resectability (90 versus 68 per cent; P = 0.007). Major complications (26 versus 34 per cent; P = 0.550) and 90-day mortality (3 versus 16 per cent respectively, P = 0.065) were comparable. Multivariable analysis confirmed that these effects were independent of confounders. CONCLUSION: PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience. [less ▲]

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See detailComparative dosimetry between (99m)Tc-MAA SPECT/CT and (90)Y PET/CT in primary and metastatic liver tumors.
JADOUL, Alexandre ULiege; Bernard, Claire ULiege; LOVINFOSSE, Pierre ULiege et al

in European journal of nuclear medicine and molecular imaging (2020), 47(4), 828-837

INTRODUCTION: The aim of this study is to determine whether (99m)Tc-MAA SPECT/CT-based dosimetry could predict the actual absorbed dose in hepatocellular carcinoma (HCC) or liver metastases, treated by ... [more ▼]

INTRODUCTION: The aim of this study is to determine whether (99m)Tc-MAA SPECT/CT-based dosimetry could predict the actual absorbed dose in hepatocellular carcinoma (HCC) or liver metastases, treated by glass or resin microspheres. MATERIAL AND METHODS: Fifty-seven patients who underwent selective internal radiation therapy (SIRT) were retrospectively included in the study, for a total of 59 treatments. Nineteen HCC were treated by resin microspheres (HCC-SIR), 20 HCC with glass microspheres (HCC-Thera), and 20 liver metastases with resin microspheres (Metastases-SIR). The mean absorbed doses in tumoral liver (Dm) and non-tumoral liver (DmNTL) were determined on the (99m)Tc-MAA SPECT/CT and the (90)Y PET/CT, and compared with each other. RESULTS: DmNTL was < 50 Gy in the 3 groups, with a strong correlation in all population, albeit slightly lower in Metastases-SIR than HCC-SIR and HCC-Thera (CCC 0.8, 0.94 and 0.96, respectively). In tumoral liver, Dm was higher in HCC than metastases (159 ± 117 Gy versus 63 ± 31 Gy). (99m)Tc-MAA SPECT/CT proved to be a better indicator of Dm in HCC compared with metastases, with similar (99m)Tc-MAA-(90)Y concordance in resin and glass microspheres (CCC HCC-SIR 0.82, CCC HCC-Thera 0.82, and CCC Metastases-SIR 0.52). CONCLUSION: (99m)Tc-MAA SPECT/CT is a reasonably reliable tool for predicting the dose to the non-tumoral liver in both HCC and metastases, regardless of the type of microspheres. It is also fairly reliable for predicting the tumor dose in HCC, again regardless of the type of spheres, although individual variations are observed. [less ▲]

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See detailInter-observer variability of 90Y PET/CT dosimetry in hepatocellular carcinoma after glass microspheres transarterial radioembolization
Meyers, Nicolas ULiege; JADOUL, Alexandre ULiege; BERNARD, Claire ULiege et al

in EJNMMI Research (2020)

Introduction: Strong correlation has been demonstrated between tumor dose and response and between healthy liver dose and side effects. Individualized dosimetry is increasingly recommended in the current ... [more ▼]

Introduction: Strong correlation has been demonstrated between tumor dose and response and between healthy liver dose and side effects. Individualized dosimetry is increasingly recommended in the current clinical routine. However, hepatic and tumor segmentations could be complex in some cases. The aim of this study is to assess the reproducibility of the tumoral and non-tumoral liver dosimetry in selective internal radiation therapy (SIRT). Material and methods: Twenty-three patients with hepatocellular carcinoma (HCC) who underwent SIRT with glass microspheres were retrospectively included in the study. Tumor (TV) and total liver volumes (TLV), and mean absorbed doses in tumoral liver (TD) and non-tumoral liver (THLD) were determined on the 90Y PET/CT studies using Simplicit90YTM software, by three independent observers. Dosimetry datasets were obtained by a medical physicist helped by a nuclear medicine (NM) physician with 10 years of experience (A), by a NM physician with 4-year experience (B), and by a resident who first performed 10 dosimetry assessments as a training (C). Inter-observer agreement was evaluated using intra-class correlation coefficients (ICC), coefficients of variation (CV), Bland-Altman plots, and reproducibility coefficient (RDC). Results: A strong agreement was observed between all three readers for estimating TLV (ICC 0.98) and THLD (ICC 0.97). Agreement was lower for TV delineation (ICC 0.94) and particularly for TD (ICC 0.73), especially for the highest values. Regarding TD, the CV (%) was 26.5, 26.9, and 20.2 between observers A and B, A and C, and B and C, respectively, and the RDC was 1.5. Regarding THLD, it was 8.5, 12.7, and 9.4, and the RDC was 1.3. Conclusion: Using a standardized methodology, and regardless of the different experiences of the observers, the estimation of THLD is highly reproducible. Although the reproducibility of the assessment of tumor irradiation is overall quite high, large variations may be observed in a limited number of patients. [less ▲]

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See detailLeft Cardiac Migration of a Lung Fiducial Marker
Cousin, François ULiege; GERARD, Laurent ULiege; Joskin, J.

in Journal of Vascular and Interventional Radiology (2019), 30(3), 445

[No abstract available]

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