[Comparison between PET(-FDG) and computed tomography in the staging of lung cancer. Consequences for operability in 94 patients]. / Comparaison entre TEP(-FDG) et scanner dans le bilan d'extension du cancer bronchopulmonaire, conséquences pour l'opérabilité chez 94 patients.

INTRODUCTION: Lung cancer, a major application of FDG/PET-CT, has recently been introduced in daily practice in France. The authors retrospectively studied its impact on the management of this disease. METHODS: The results of PET-CT and conventional assessment (brain imaging, chest and abdominal CT and possibly bone scintigraphy) were compared in 94 patients, referred for the staging of non-small cell lung cancer, or the assessment of a solitary lung lesion. The impact of thoracic lymph node involvement on the operability of patients was studied in 44 patients. RESULTS: PET-CT revealed metastases in 20% of the patients without metastases found by conventional imaging and modified the stage of the disease in 28% of the cases. It changed the indication of surgical treatment in 19% of the cases and led to induction chemotherapy in two patients. In addition, two synchronous cancers were discovered. Regarding lymph node involvement, PET-CT remains of diagnostic value regardless of the scanner results. CONCLUSION: The impact of PET-CT in assessing non-small cell lung cancer was confirmed in the authors' practice. Its interest and the consequences in some patients misclassified with conventional assessment have been demonstrated.

High-grade lymphoma of the bladder visualized on PET.

F-18 FDG PET is used for the staging of many cancers. One of its limits is the analysis of the pelvis and the urinary tract because of physiological radiotracer excretion. We report a rare case of an 82-year-old woman in whom intravenous administration of diuretics (furosemide) allowed the identification of a primary diffuse large B-cell lymphoma of the bladder wall. This pharmaceutical increases urine flow and, therefore, reduces the concentration of radiotracer in the urinary tract, improving the visualization of pelvic or urinary tumors. Furosemide administration is an easy, safe, and noninvasive method, even in case of renal insufficiency. Newer PET cameras with high-performance crystals allow rapid acquisitions and improve the tolerance of an examination with diuretic injection. The 3-dimensional reconstruction of images in new PET cameras reduces the occurrence of hyperactive bladder artifacts. The present case illustrates the advantages of furosemide in a rare pathologic entity.

Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain.

An anatomical parcellation of the spatially normalized single-subject high-resolution T1 volume provided by the Montreal Neurological Institute (MNI) (D. L. Collins et al., 1998, Trans. Med. Imag. 17, 463-468) was performed. The MNI single-subject main sulci were first delineated and further used as landmarks for the 3D definition of 45 anatomical volumes of interest (AVOI) in each hemisphere. This procedure was performed using a dedicated software which allowed a 3D following of the sulci course on the edited brain. Regions of interest were then drawn manually with the same software every 2 mm on the axial slices of the high-resolution MNI single subject. The 90 AVOI were reconstructed and assigned a label. Using this parcellation method, three procedures to perform the automated anatomical labeling of functional studies are proposed: (1) labeling of an extremum defined by a set of coordinates, (2) percentage of voxels belonging to each of the AVOI intersected by a sphere centered by a set of coordinates, and (3) percentage of voxels belonging to each of the AVOI intersected by an activated cluster. An interface with the Statistical Parametric Mapping package (SPM, J. Ashburner and K. J. Friston, 1999, Hum. Brain Mapp. 7, 254-266) is provided as a freeware to researchers of the neuroimaging community. We believe that this tool is an improvement for the macroscopical labeling of activated area compared to labeling assessed using the Talairach atlas brain in which deformations are well known. However, this tool does not alleviate the need for more sophisticated labeling strategies based on anatomical or cytoarchitectonic probabilistic maps.

Amplitude measurements of Faraday waves.

A light reflection technique is used to measure quantitatively the surface elevation of Faraday waves. The performed measurements cover a wide parameter range of driving frequencies and sample viscosities. In the capillary wave regime the bifurcation diagrams exhibit a frequency independent scaling proportional to the wavelength. We also provide numerical simulations of the full Navier-Stokes equations, which are in quantitative agreement up to supercritical drive amplitudes of epsilon approximately equal 20%. The validity of an existing perturbation analysis is found to be limited to epsilon<2.5%.

Picture naming without Broca's and Wernicke's area.

Lexical and semantic retrieval was investigated in normal volunteers with PET by comparing picture confrontation naming and verb generation related to the same pictures. Conjunction analysis of the naming and verb generation uncovered a common network including the occipito-temporal ventral pathway for object recognition, and the bilateral anterior insula, SMA and precentral gyrus for coordination, planning and overt word production. Naming and verb generation highlighted two different patterns: verb generation showed specific implication of Broca and Wernicke's areas, whereas naming specifically relied on the primary visual areas, the right fusiform and parahippocampal gyri and the left anterior temporal region. These results indicate that speech does not necessarily involve the Wernicke-Broca's language network and testify that naming relies on an early developmental language network.

A common language network for comprehension and production: a contribution to the definition of language epicenters with PET.

In this paper, we report on a PET activation study designed to assess whether functional neuroimaging would help to uncover essential language areas in normal volunteers and to provide a more accurate definition of their localization. Regional cerebral blood flow was repeatedly monitored in eight right-handed male volunteers, while performing a language comprehension task (listening to factual stories) and a language production task (covert generation of verbs semantically related to heard nouns), using silent resting as a control condition. The conjunction analysis, conducted with SPM, was used to uncover the network of activations common to both task that included three left hemisphere areas, namely (1) the pars opercularis and triangularis of the inferior frontal gyrus, (2) the posterior part of the superior temporal cortex centered around the superior temporal sulcus, extending to the planum temporale posterior part but sparing the supramarginalis and angular gyri, and (3) the most anterior part of the left inferior temporal gyrus at the junction with the anterior fusiform gyrus. The inferior and lateral parts of the right cerebellar cortex were also included in the conjunction network. Each of the three cortical areas, when they are site of lesion or electrical stimulation, elicit impairment in both language comprehension and production and can thus be considered as essential to language. Accordingly, the present results provide conservative anatomofunctional definitions of the Broca, Wernicke, and basal language areas. Interestingly, contralateral homologues of Broca's and Wernicke's areas also lighted up in the conjunction analysis that could be related to the interindividual variability of hemispheric language dominance.

FMRI and PET of self-paced finger movement: comparison of intersubject stereotaxic averaged data.

We compared the intersubject-averaged functional anatomy of self-paced right index finger movement as revealed by (15)O water positron emission tomography (PET) and blood oxygen level-dependent functional magnetic resonance imaging (FMRI) at 1.5 T. Image data sets were acquired with both techniques on a group of eight subjects, spatially normalized in the stereotaxic space and subsequently processed in order to get identical smoothness and degrees of freedom. Intersubject-averaged PET and FMRI activation maps were found congruent in the left primary sensorimotor area (PSM), bilateral supplementary motor area, bilateral supra marginalis gyri, left operculum, left inferior parietal lobule, right middle frontal gyrus, and right cerebellum. In those regions the mean distance between PET and FMRI local maxima was 7.4 mm. FMRI detected additional activations in the right precentral gyrus, right rolandic operculum, right inferior parietal lobule, and bilateral insula, whereas PET demonstrated a higher detection sensitivity at the deep nuclei level. PET and FMRI percentage signal variations were found linearly related by a factor around 10, both within the PSM and across a set of distributed local extrema. However, in most cases, FMRI was more sensitive than PET, as assessed by t values. Finally the pattern of deactivations was markedly dissimilar between the two techniques, possibly due to differences in the "Rest" control task.