Five simultaneous artificial intelligence data challenges on ultrasound, CT, and MRI.

PURPOSE: The goal of this data challenge was to create a structured dynamic with the following objectives: (1) teach radiologists the new rules of General Data Protection Regulation (GDPR), while building a large multicentric prospective database of ultrasound, computed tomography (CT) and MRI patient images; (2) build a network including radiologists, researchers, start-ups, large companies, and students from engineering schools, and; (3) provide all French stakeholders working together during 5 data challenges with a secured framework, offering a realistic picture of the benefits and concerns in October 2018. MATERIALS AND METHODS: Relevant clinical questions were chosen by the Société Francaise de Radiologie. The challenge was designed to respect all French ethical and data protection constraints. Multidisciplinary teams with at least one radiologist, one engineering student, and a company and/or research lab were gathered using different networks, and clinical databases were created accordingly. RESULTS: Five challenges were launched: detection of meniscal tears on MRI, segmentation of renal cortex on CT, detection and characterization of liver lesions on ultrasound, detection of breast lesions on MRI, and characterization of thyroid cartilage lesions on CT. A total of 5,170 images within 4 months were provided for the challenge by 46 radiology services. Twenty-six multidisciplinary teams with 181 contestants worked for one month on the challenges. Three challenges, meniscal tears, renal cortex, and liver lesions, resulted in an accuracy>90%. The fourth challenge (breast) reached 82% and the lastone (thyroid) 70%. CONCLUSION: Theses five challenges were able to gather a large community of radiologists, engineers, researchers, and companies in a very short period of time. The accurate results of three of the five modalities suggest that artificial intelligence is a promising tool in these radiology modalities.

Imaging features of lower limb malformations above the foot.

Lower limb malformations are generally isolated or sporadic events. However, they are sometimes associated with other anomalies of the bones and/or viscera in patients with constitutional syndromes or disorders of the skeleton. This paper reviews the main imaging features of these abnormalities, which generally exhibit a broad spectrum. This paper focuses on several different bone malformations: proximal focal femoral deficiency, congenital short femur and femoral duplication for the femur, tibial hemimelia (aplasia/hypoplasia of the tibia) and congenital bowing for the tibia, fibular hemimelia (aplasia/hypoplasia) for the fibula, and aplasia, hypoplasia and congenital dislocation for the patella.

[Cutaneous neuroendocrine carcinoma. Apropos of a case]. / Le carcinome neuroendocrine cutané. A propos d'une observation.

Cutaneous neuroendocrine carcinoma (CNEC) is a rare tumour. We report the case of a 75-year old woman affected with a rapidly progressive CNEC of the right cheek which kept recurring despite surgical excision followed by radiotherapy. The clinical features of CNEC are not specific. The tumour is located in the dermis, and the tumoral cells (Merkel cells) have a monotonous appearance. Gould's classification of these carcinomas into three types has a prognostic value. Immunohistochemistry is a mandatory complement to light microscope examination. It is very difficult to distinguish between CNEC and metastasis from a visceral small cell carcinoma. Treatment consists of surgery combined with radiotherapy. Chemotherapy was very successful in our patient and should be considered in other cases.

[Value of liver biopsy in internal medicine. Apropos of a series of 300 puncture biopsies]. / Intérêt de la biopsie hépatique en médecine interne. A propos d'une série de 300 ponctions-biopsies.

Between April 1976 and March 1987, in an Internal Medicine department some 300 unguided percutaneous liver biopsies were performed, using the Tru-Cut excision needle. The procedure contributed to the diagnosis in 76.2% of the cases. In alcoholism-related pathology with its specific lesions, liver biopsy is particularly useful in diagnosing incipient fatty degeneration and hepatitis and helps in the prognosis of cirrhosis. In chronic hepatitis, it asserts the diagnosis and provides aetiological and prognostic data. The finding of granulomas at histology sometimes clinches a hitherto undecided diagnosis : sarcoidosis or tuberculosis? The diagnosis of drug-induced hepatitis rests on convergent clinical, biochemical and histological elements. In blood diseases, liver biopsy is of interest on three scores: it shows whether or not the liver is involved, detects intercurrent complications and evaluates the extent of the lesions before treatment. When performed after ultrasonography, it enables intrahepatic cholestasis to be recognized and extrahepatic cholestasis, unidentified by ultrasounds, to be suspected. In primary biliary cirrhosis, it confirms the diagnosis and informs on the severity and progressiveness of the disease. In hepatic cancers, liver biopsy has recently been superseded by computerized tomography and ultrasonography. Finally, it largely contributes to the diagnosis of overload disease and evaluates their activity and their impact on the liver.