Artificial intelligence solution to classify pulmonary nodules on CT.

PURPOSE: The purpose of this study was to create an algorithm to detect and classify pulmonary nodules in two categories based on their volume greater than 100 mm3 or not, using machine learning and deep learning techniques. MATERIALS AND METHOD: The dataset used to train the model was provided by the organization team of the SFR (French Radiological Society) Data Challenge 2019. An asynchronous and parallel 3-stages pipeline was developed to process all the data (a data "pre-processing" stage; a "nodule detection" stage; a "classifier" stage). Lung segmentation was achieved using 3D U-NET algorithm; nodule detection was done using 3D Retina-UNET and classifier stage with a support vector machine algorithm on selected features. Performances were assessed using area under receiver operating characteristics curve (AUROC). RESULTS: The pipeline showed good performance for pathological nodule detection and patient diagnosis. With the preparation dataset, an AUROC of 0.9058 (95% confidence interval [CI]: 0.8746-0.9362) was obtained, 87% yielding accuracy (95% CI: 84.83%-91.03%) for the "nodule detection" stage, corresponding to 86% specificity (95% CI: 82%-92%) and 89% sensitivity (95% CI: 84.83%-91.03%). CONCLUSION: A fully functional pipeline using 3D U-NET, 3D Retina-UNET and classifier stage with a support vector machine algorithm was developed, resulting in high capabilities for pulmonary nodule classification.

Treatment of an ilio-caval thrombosis by mechanical thrombolysis.

In proximal deep vein thrombosis, thrombolytic treatment is more effective than heparin from a recanalization point of view but with a failure rate of 20%. We describe an interventional therapeutic procedure that may be effective in these cases. Mechanical thrombolysis with the thrombolizer (Angiocor, Lille Hellemmes, France) has been tried in 2 cases of deep vein thrombosis, when systemic thrombolysis alone had failed.

[Late recurrence of a large post-infarction left ventricular pseudo-aneurysm. A case report]. / Récidive tardive d'un volumineux faux anévrysme ventriculaire gauche postinfarctus. A propos d'une observation.

Left ventricular pseudo-aneurysm is a neo-cavity characterised by the presence of a narrow neck and a wall consisting of fibrous tissue and thrombotic debris without any muscular cells. The diagnosis must be made as soon as possible by non-invasive methods (echocardiography, CT scan, MRI ...) or by angiography before early surgical treatment, in view of the high risk of secondary rupture. The authors report this original case of a post-infarction left ventricular pseudoaneurysm which recurred five years after initial surgical cure.

[Pancreatic-portal fistula. A rare complication of chronic pancreatitis]. / La fistule pancréatico-portale. Une complication rare de la pancréatite chronique.

We report a 40-year-old patient with complication of chronic pancreatitis as a pancreatico-portal fistula. The patient had subcutaneous nodular fat necrosis of the lower limbs resembling Weber-Christian syndrome, and amylasic ascitis. The diagnosis was established with retrograde endoscopic cholangio-pancreatography which found three pancreatic pseudocysts and a communication with the portal venous system. A portal thrombosis with cavernum was studied with color echo-Doppler and arteriography. The echo-endoscopy was performed for the first time in this complication and its significance estimated. The evolution was quickly and spontaneously favourable. That is a very rare complication of chronic pancreatitis and an expectant conservative management can be adopted.

[Pseudo-diastrophic dysplasia]. / La dysplasie pseudo-diastrophique.

A new case of pseudo-diastrophic dysplasia in a boy born to consanguineous parents is reported. The patient developed neurologic (hydrocephalus) and respiratory anomalies and died at the age of 11 months of an unknown cause. Features that distinguish this chondrodysplasia from diastrophic dysplasia include decreased height of vertebral bodies and anomalies of the pelvis with short iliac wings and a horizontal orientation of the internal spine of the acetabular roof.