Publications by authors named "Sébastien Cimarelli"

15 Publications

  • Page 1 of 1

Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study.

Crit Care 2014 Jun 25;18(3):R131. Epub 2014 Jun 25.

Introduction: Although aneurysmal subarachnoid hemorrhage (SAH) is often complicated by myocardial injury, whether this neurogenic cardiomyopathy is associated with the modification of cardiac metabolism is unknown. This study sought to explore, by positron emission tomography/computed tomography, the presence of altered cardiac glucose metabolism after SAH.

Methods: During a 16-month period, 30 SAH acute phase patients underwent myocardial (18)F- fluorodesoxyglucose positron emission tomography ((18)F-FDGPET), (99m)Tc-tetrofosmin and (123)I-meta-iodobenzylguanidine ((123)I-mIBG) scintigraphy, respectively, assessing glucose metabolism, cardiac perfusion, and sympathetic innervation. Patients with initial abnormalities were followed monthly for two months for (18)F-FDG, and six months later for (123)I-mIBG.

Results: In this SAH population, acute cardiac metabolic disturbance was observed in 83% of patients (n = 25), and sympathetic innervation disturbance affected 90% (n = 27). Myocardial perfusion was normal for all patients. The topography and extent of metabolic defects and innervation abnormalities largely overlapped. Follow-up showed rapid improvement of glucose metabolism in one or two months. Normalization of sympathetic innervation was slower; only 27% of patients (n = 8) exhibited normal (123)I-mIBG scintigraphy after six months. Presence of initial altered cardiac metabolism was not associated with more unfavorable cardiac or neurological outcomes.

Conclusions: These findings support the hypothesis of neurogenic myocardial stunning after SAH. In hemodynamically stable acute phase SAH patients, cardiomyopathy is characterized by diffuse and heterogeneous (18)F-FDG and (123)I-mIBG uptake defect.

Trial Registration: Clinicaltrials.gov NCT01218191. Registered 6 October 2010.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/cc13943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230019PMC
June 2014

Takotsubo cardiomyopathy: an integrated multi-imaging approach.

Eur Heart J Cardiovasc Imaging 2014 Apr 14;15(4):366-77. Epub 2013 Oct 14.

Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy.

Takotsubo cardiomyopathy (TTC) is a distinct clinical entity characterized by the presence of transient left ventricular wall dysfunction without significant culprit obstructive coronary artery disease. Invasive coronary angiography and ventriculography are the 'gold standard' for definitive diagnosis, with an integrated multi-modality imaging approach offering advantages in various clinical scenarios. Echocardiography is a widely available, first-line, non-invasive imaging technique appropriate both in emergency setting to confirm diagnosis, assess for various potential acute complications, and in serial follow-up to track myocardial recovery. Cardiac magnetic resonance (CMR) may be helpful to discriminate TTC from other acute cardiac syndromes with troponin elevation and ventricular dysfunction. Echocardiography, CMR, and nuclear imaging may also provide new insights into possible underlying pathophysiological mechanisms, and myocardial (123)I-metaiodobenzyl-guanidine imaging may have a role for retrospective diagnosis in the subacute phase of late-presenting cases. The potential diagnostic role of coronary computed tomography angiography in the emergency room requires a further study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ehjci/jet167DOI Listing
April 2014

Primary cerebral angioimmunoblastic T-cell lymphoma.

J Clin Oncol 2013 Feb 7;31(5):e64-8. Epub 2013 Jan 7.

Department of Oncology and Hematology, Hôpital Pierre Oudot, 30 Blvd du médipôle, 38300 Bourgoin-Jallieu, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1200/JCO.2012.43.8226DOI Listing
February 2013

Additional Benefit of F-18 FDG PET/CT in the staging and follow-up of pediatric rhabdomyosarcoma.

Clin Nucl Med 2011 Aug;36(8):672-7

Service de Médecine Nucléaire, Centre Léon-Bérard, Université de Lyon, Lyon, France.

Purpose: The therapeutic management of rhabdomyosarcoma (RMS) is strongly dependent on initial staging. This study aimed to evaluate F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) as an adjunct to conventional imaging (CI) in the staging and follow-up of pediatric RMS.

Materials And Methods: A total of 13 consecutive children and adolescents (12 males, 1 female; mean age, 9.6 years) with histologically proven RMS (10 alveolar, 3 embryonal), in whom FDG PET/CT was performed at staging and follow-up, were retrospectively included. In total, 35 FDG PET/CT were compared with CI (MRI, CT, and bone scintigraphy) performed with a less than a 15-day interval. Histologic data, follow-up (mean, 27 months), and the final judgment of a multidisciplinary tumor board were considered as the standard of reference for result interpretation.

Results: At staging, FDG PET/CT revealed 1 RMS of the prostate missed by CI, and found 19 true-positive lymph node territories in 4 patients and 11 bone metastases in 3 patients, versus 12 and 3, respectively, with CI. Conversely, FDG PET/CT was less sensitive for detecting infracentimetric lung nodules in 1 patient. On the whole analysis, FDG PET/CT modified lymph node staging in 4 of 13 patients, bone involvement in 2 patients, and led to treatment alteration in 2 children.

Conclusions: FDG PET/CT can be useful in staging and restaging pediatric RMS, especially for assessing lymph nodes and bone involvement, and for detecting unknown primary sites of RMS, with potential therapeutic strategy alteration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/RLU.0b013e318217ae2eDOI Listing
August 2011

Use of F-18 FDG PET/CT in non-Hodgkin lymphoma with central nervous system involvement.

Clin Nucl Med 2011 Jun;36(6):e45-9

Département de Médecine Nucléaire, Centre Léon-Bérard, Université de Lyon, Lyon, France.

Central nervous system (CNS) is a rare site of involvement by non-Hodgkin lymphoma (NHL). Therapeutic approach for primary and secondary CNS NHL is different and remains challenging. Therefore imaging data are essential at staging to discriminate these 2 clinical entities and during follow-up to assess therapy response. The adjunct role of positron emission tomography using F-18 fluorodeoxyglucose to morphologic imaging is still undefined. We report 2 didactic cases of primary and secondary CNS NHL assessed by F-18 fluorodeoxyglucose positron emission tomography. Metabolic imaging seems to be complementary to conventional imaging techniques for the extent-of-disease evaluation and therapy monitoring of CNS lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/RLU.0b013e31821739e3DOI Listing
June 2011

Value of PET-FDG in primary breast cancer based on histopathological and immunohistochemical prognostic factors.

Int J Clin Oncol 2010 Dec 1;15(6):588-93. Epub 2010 Sep 1.

Department of Medical Oncology, Léon Bérard Cancer Center, 28 Rue Laennec, 69008 Lyon, France.

Background: The aim of the study was to analyze in breast tumors the correlation between [(18)F]fluorodeoxyglucose (FDG) uptake assessed by positron emission tomography (PET) and histopathological and immunohistochemical prognostic factors.

Methods: FDG-PET combined with computed tomography (CT) was performed before surgery in 45 women with biopsy-proven primary breast cancer. The standardized uptake value (SUV) was compared with histopathological findings after surgery.

Results: A positive relationship was found between SUV and histological grade (p < 0.0001), histological type (p = 0.001), tumor size (p < 0.0435), estrogen receptor status (p < 0.0005), and progesterone receptor status (p = 0.002). FDG-PET/CT revealed unknown distant metastatic lesions in 2 of 12 patients with triple-negative breast cancer. The sensitivity of FDG-PET/CT for detecting axillary lymph node metastases was, respectively, 21% and 100% for pN1 and pN2 cases, whereas specificity was 100% for pN0.

Conclusion: SUV, a preoperative and noninvasive metabolic parameter, correlates with other known prognostic factors in breast cancer. This study provides valuable insight into the usefulness of FDG-PET/CT for preoperative staging of patients with triple-negative and poorly differentiated breast tumors but not for evaluating axillary lymph nodes and lobular carcinomas.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10147-010-0120-3DOI Listing
December 2010

F-18 FDG PET/CT imaging in a case of primary choriocarcinoma in the retroperitoneum.

Clin Nucl Med 2009 Jul;34(7):449-51

Service de Médecine Nucléaire, Centre Léon Bérard, Université de Lyon, Lyon, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/RLU.0b013e3181a7d0cdDOI Listing
July 2009

Transient left ventricular dysfunction syndrome: patho-physiological bases through nuclear medicine imaging.

Int J Cardiol 2010 Oct 13;144(2):212-8. Epub 2009 May 13.

Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg Cedex, France.

Background: Takotsubo cardiomyopathy (TTC) is a novel heart disease, mimicking acute myocardial infarction. The term "transient left ventricular dysfunction syndrome" (TLVDS) seems to be more appropriate since variant forms of TTC sparing apical segments (mid-ventricular ballooning syndrome (MVBS) and inverted TTC) have been described. Patho-physiological bases of TLVDS remain poorly understood and its optimal management is until now empirical. Our aim was to characterize patho-physiological mechanisms of TLVDS by means of nuclear medicine procedures and to discuss the clinical usefulness of isotopic imaging for a non-invasive diagnosis of TLVDS.

Methods And Results: During the sub acute phase, eighteen patients with TLVDS (13 TTC and 5 MVBS) underwent myocardial (99m)Tc-tetrofosmin or (201)Thallium Gated Single Photon Emission Computed Tomography (G-SPECT) (n=11), (123)I-mIBG SPECT (n=8) and (18)F-FDG Gated Positron Emission Tomography (G-PET) (n=15), assessing respectively LV perfusion, sympathetic innervation and glucose metabolism. Hypocontractile LV segments were characterized by normal perfusion but reduced uptake of (18)F-FDG and (123)I-mIBG. Topography and extent of metabolic defects and innervation abnormalities were largely overlapping. Follow-up (123)I-mIBG SPECT and (18)F-FDG G-PET were performed in selected patients showing rapid normalization of LV motion and progressive improvement of both glucose metabolism and sympathetic innervation.

Discussion: With the hypothesis of neurogenic stunned myocardium as the central causative mechanism of TLVDS, (123)I-mIBG SPECT seems to be the most specific diagnostic technique. Sympathetic function and glucose metabolism seem to be strictly correlated in the hypocontractile LV segments. Finally, our results underline the role of nuclear imaging in the setting of patho-physiological mechanisms of TLVDS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijcard.2009.04.025DOI Listing
October 2010

Importance of inflammation and neurohumoral activation in Takotsubo cardiomyopathy.

J Card Fail 2009 Apr 23;15(3):206-13. Epub 2008 Dec 23.

Pôle d'Activité Médico-Chirurgicale des Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, France.

Background: To gain more insight into the involvement of inflammatory response and neurohumoral activation in Takotsubo cardiomyopathy (TTC), we investigated C-reactive protein (CRP), leukocytes, plasma catecholamines levels, iodine 123 meta-iodobenzylguanidine (123I-mIBG) myocardial uptake, myocardial perfusion (thallium 201 [201Tl] or technetium [Tc] 99m-tetrofosmin myocardial single photon emission computed tomography [SPECT]), and metabolism (fluorine 18-fluorodeoxyglucose positron emission tomography).

Methods And Results: Inflammatory status and brain natriuretic peptide (BNP) levels in 17 patients with TTC were compared with 14 age-matched patients. In TTC, elevated levels of CRP were evidenced on admission, reaching a peak in the following days (P < .01). CRP levels were correlated to baseline left ventricular ejection fraction (LVEF) and BNP levels (P < .05). Leukocytes were correlated to BNP and noradrenaline levels. Myocardial 123I-mIBG SPECT showed a reduced activity in the midventricle and apex corresponding to 35% +/- 23% of the total myocardial mass, partially reversible at follow-up. An identical pattern was retrieved when assessing myocardial glucose metabolism. At rest, no relevant abnormalities of myocardial perfusion could be evidenced at the subacute phase.

Conclusion: Inflammatory status in TTC was related to LVEF impairment and to the extent of neurohormonal activation. The hypothesis of a catecholamine-induced myocardial "stunning" is emphasized by the evidence of a reduced 123I-mIBG myocardial activity, impairment of myocardial glucose metabolism, and wall motion kinetic after the same temporospatial distribution.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cardfail.2008.10.031DOI Listing
April 2009

Desmoplastic small round cell tumor: impact of F-FDG PET induced treatment strategy in a patient with long-term outcome.

Rare Tumors 2009 Jul 22;1(1):e19. Epub 2009 Jul 22.

Service de Biophysique et de Médecine Nucléaire, Hôpital de Hautepierre, Strasbourg, France;

The desmoplastic small round cell tumor (DSRCT) is an uncommon and highly aggressive cancer. The role of (18)F-FDG PET in management of DSRCT is little reported. We report a case of metastasized abdominal DSRCT detected in a 43-year old patient whose diagnostic and therapeutic approaches were influenced by (18)F-FDG PET-CT. The patient is still alive ten years after diagnosis. (18)F-FDG PET-CT seems to be a useful method for assessing therapeutic efficiency and detecting early recurrences even in rare malignancies such as DSRCT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4081/rt.2009.e19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994440PMC
July 2009

Nuclear medicine imaging of takotsubo cardiomyopathy: typical form and midventricular ballooning syndrome.

J Nucl Cardiol 2008 Jan-Feb;15(1):137-41. Epub 2007 Dec 21.

Service de Biophysique et de Médecine Nucléaire, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/BF02976903DOI Listing
February 2008

[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for early evaluation of treatment efficacy in advanced non-Hodgkin lymphoma of uterine corpus: a case report.

Clin Lymphoma Myeloma 2007 May;7(6):421-4

Service de Biophysique et de Médecine Nucléaire, Hôpital de Hautepierre, 1 Avenue Molière, 67098 Strasbourg Cedex, France.

We report a case of diffuse large B-cell lymphoma occurring in a patient with the hyperimmunoglobulinemia E syndrome, a rare immune disorder defined by elevated immunoglobulin E levels and recurrent bacterial and fungal infections often manifesting as cold abscesses. This case further supports the notion that patients with hyperimmunoglobulinemia E have an increased risk of lymphoid malignancies and should be closely monitored. Despite a theoretic risk of severe infectious complications, chemotherapy was well tolerated and resulted in a sustained complete remission.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3816/CLM.2007.n.021DOI Listing
May 2007

Focal F-18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images.

Clin Nucl Med 2006 Dec;31(12):835-7

Hopital de Hautepierre, Service de Biophysique et de Medecine Nucleaire, Strasbourg, France.

Diffuse, increased gastric wall F-18 FDG uptake is widely observed during PET/CT examinations, frequently unrelated to malignant findings, but simply caused by inflammatory disease, physiological emptying, or visceral thickening. Hence, elevated F-18 FDG gastric uptake can lead to equivocal misinterpretation, especially in patients with known gastric malignant disease, at posttherapy reevaluation. Gastric wall contraction can increase F-18 FDG uptake, especially for a remnant stomach, increasing the percentage of false-positive results with a direct impact on therapeutic management. One field PET/CT acquisition centered on the hypochondrial regions a few minutes after water ingestion should be performed routinely if standard images are doubtful (increased tracer uptake and visceral thickening) to differentiate benign from malignant uptake.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/01.rlu.0000246819.37532.e2DOI Listing
December 2006