Clinical implementation of deep-learning based auto-contouring tools-Experience of three French radiotherapy centers.

Deep-learning (DL)-based auto-contouring solutions have recently been proposed as a convincing alternative to decrease workload of target volumes and organs-at-risk (OAR) delineation in radiotherapy planning and improve inter-observer consistency. However, there is minimal literature of clinical implementations of such algorithms in a clinical routine. In this paper we first present an update of the state-of-the-art of DL-based solutions. We then summarize recent recommendations proposed by the European society for radiotherapy and oncology (ESTRO) to be followed before any clinical implementation of artificial intelligence-based solutions in clinic. The last section describes the methodology carried out by three French radiation oncology departments to deploy CE-marked commercial solutions. Based on the information collected, a majority of OAR are retained by the centers among those proposed by the manufacturers, validating the usefulness of DL-based models to decrease clinicians' workload. Target volumes, with the exception of lymph node areas in breast, head and neck and pelvic regions, whole breast, breast wall, prostate and seminal vesicles, are not available in the three commercial solutions at this time. No implemented workflows are currently available to continuously improve the models, but these can be adapted/retrained in some solutions during the commissioning phase to best fit local practices. In reported experiences, automatic workflows were implemented to limit human interactions and make the workflow more fluid. Recommendations published by the ESTRO group will be of importance for guiding physicists in the clinical implementation of patient specific and regular quality assurances.

[Stereotactic body radiotherapy: Prospective study to evaluate asthenia and quality of life]. / Radiothérapie en conditions stéréotaxiques : étude prospective évaluant la fatigue et la qualité de vie.

PURPOSE: To evaluate prospectively asthenia and the quality of life in patients treated by stereotactic body irradiation and to determine their predictive factors. METHODS AND MATERIALS: Quality of life was assessed by the EORTC QLQ-C30 and asthenia was evaluated with the Brief Fatigue Inventory (BFI), on the first day (T1), last day (T2) and 1-3 weeks after the end of treatment (T3). RESULTS: Sixty-three patients were treated with stereotactic body irradiation from February 2017 to May 2017 and 41 were included in the analysis (22 patients excluded for lack of understanding, organization, psychologic disorders or refusal). The mean number of fractions was 5 (±2). The compliance to quality of life assessment was 98%, 95% was 81% at T1, T2 and T3, respectively. An increase of asthenia and a worsened quality of life were found in 12 (29%) and 14 (34%) patients between T1 and T2. Univariate analysis demonstrated a correlation between asthenia and quality of life were correlated with performans status (P=0.03 and 0.05 respectively), hemoglobin level (p=0.01 and 0.004), albumin level (P=0.01 and 0.06), distance between home and radiotherapy department (P=0.05 and 0.02). Multivariate analysis demonstrated a correlation between female gender (P=0.012), albumin level (P<0.001), distance over 25km (P<0.001) with asthenia, and albumin level (P=0.003), hemoglobin level (P=0.004) and previous chemotherapy (P=0.003) with quality of life. No influence of stereotactic body ratiotherapy parameters was seen. CONCLUSION: Despite hypofractionation, stereotactic body radiotherapy induced asthenia and deterioration of quality of life.

[Must the concept of intrinsic asthma be supported?]. / Doit-on maintenir la notion d'asthme intrinsèque?

Intrinsic asthma, defined as asthma which is not from allergy to pneumo-allergens, of cause unknown, may show several etiologies. Allergics, remembering that there in some subjects there may be small amounts of IgE on the mastocytes, with specific RAST IgE negative, skin tests only weakly positive, but with a positive provocation test to pneumo-allergens. Food allergy, isolated and associated, may also contribute a not-negligible cause. Non-allergics, responding to the frequent triggering factors: Gastro-oesophageal reflux; Neuro-endocrine origin; Infections; Physical origin (exercise). In our study, we quote two types of extremely severe asthma, linked to intolerance to aspirin and metabisulfites with others that are associated.

Comparative study of the electrochemical behavior and analytical applications of (bio)sensing platforms based on the use of multi-walled carbon nanotubes dispersed in different polymers.

This review present a critical comparison of the electrochemical behavior and analytical performance of glassy carbon electrodes (GCE) modified with carbon nanotubes (CNTs) dispersed in different polymers: polyethylenimine (PEI), PEI functionalized with dopamine (PEI-Do), polyhistidine (Polyhis), polylysine (Polylys), glucose oxidase (GOx) and double stranded calf-thymus DNA (dsDNA). The comparison is focused on the analysis of the influence of the sonication time, solvent, polymer/CNT ratio, and nature of the polymer on the efficiency of the dispersions and on the electrochemical behavior of the resulting modified electrodes. The results allow to conclude that an adequate selection of the polymers makes possible not only an efficient dispersion of CNTs but also, and even more important, the building of successful analytical platforms for the detection of different bioanalytes like NADH, glucose, DNA and dopamine.