Publications by authors named "Maite Lewin"
Aim: To evaluate R0/R1 resection rate in patients with colorectal liver metastases (CLM) treated with aflibercept plus FOLFIRI after failure of a prior oxaliplatin-based regimen in daily clinical practice.
Methods: This French, multicentre, prospective, observational cohort (NCT05178745) included patients with CLM (alone or predominant; up to 5 lung nodules <2 cm allowed) initiating aflibercept plus FOLFIRI every 2 weeks per physician choice. Primary endpoint was R0/R1 resection rate.
Background: Despite the increasing efficacy of chemotherapy, permanently unresectable colorectal liver metastases are associated with poor long-term survival. We aimed to assess whether liver transplantation plus chemotherapy could improve overall survival.
Methods: TransMet was a multicentre, open-label, prospective, randomised controlled trial done in 20 tertiary centres in Europe.
Article Synopsis
- * The French Association for the Study of the Liver created guidelines to summarize the best practices for managing iCCA and pCCA, based on comprehensive expert analysis and voting.
- * These guidelines cover the epidemiology of cholangiocarcinoma and outline management strategies from diagnosis to treatment, emphasizing advancements in personalized medicine and targeted therapies.
Article Synopsis
- Liver resection is effective for small hepatocellular carcinoma, but many patients face recurrence, making it important to identify those at a higher risk.
- A new deep learning algorithm using ResNet34 analyzed 680 whole slide images of liver specimens, achieving high accuracy (0.864 for patches, 0.823 for whole slides) in identifying risk indicators associated with HCC recurrence.
- Validated on an external dataset, the model showed promise in predicting recurrence by correlating pejorative architectural features with critical histological indicators like microvascular invasion, potentially paving the way for a comprehensive predictive tool for early post-resection recurrence.
Background: Despite the increasing efficacy of chemotherapy (C), the 5-year survival rate for patients with unresectable colorectal liver metastases (CLM) remains around 10%. Liver transplantation (LT) might offer a curative approach for patients with liver-only disease, yet its superior efficacy compared to C alone remains to be demonstrated.
Methods: The TransMet randomised multicentre clinical trial (NCT02597348) compares the curative potential of C followed by LT versus C alone in patients with unresectable CLM despite stable or responding disease on C.
Purpose: This manuscript reports on the occurrence of early and frequent erythrocytosis in advanced hepatocellular carcinoma (HCC) patients treated with lenvatinib.
Methods: A cohort of 23 patients with advanced HCC, treated with this antiangiogenic drug for at least one month, was retrospectively analyzed.
Results: These patients (82.
Background: The severity of small bowel (SB) inflammation in Crohn's disease (CD) patients is a key component of the therapeutic choice. We aimed to develop a SB-CD Magnetic Resonance Enterography (MRE) index of Inflammation Severity (CDMRIS).
Methods: Each gastroenterologist/radiologist pair in 13 centers selected MREs from 6 patients with SB-CD stratified on their perceived MRE inflammation severity.
Article Synopsis
- This study aimed to create a method for generating synthetic MR images of macrotrabecular-massive hepatocellular carcinoma (MTM-HCC) to improve imaging capabilities.* -
- Researchers used MR images from 91 patients with MTM-HCC and a separate group of 67 patients, employing a 3-step pipeline to create realistic synthetic images and evaluating them with the help of radiologists.* -
- The results showed that 1000 synthetic images were generated with consistent quality, achieving a score of 0.64 in evaluations, suggesting promising potential for these images in automatic diagnosis but indicating the need for further research.*
Background: The role of positron emission tomography/computed tomography (PET/CT) in hepatocellular carcinoma (HCC) management is not clearly defined. Our objective was to analyze the utility of dual-PET/CT (F-FDG + F-Choline) imaging findings on the BCLC staging and treatment decision for HCC patients.
Methods: Between January 2011 and April 2019, 168 consecutive HCC patients with available baseline dual-PET/CT imaging data were retrospectively analyzed.
Purpose: The 2021 edition of the Artificial Intelligence Data Challenge was organized by the French Society of Radiology together with the Centre National d'Études Spatiales and CentraleSupélec with the aim to implement generative adversarial networks (GANs) techniques to provide 1000 magnetic resonance imaging (MRI) cases of macrotrabecular-massive (MTM) hepatocellular carcinoma (HCC), a rare and aggressive subtype of HCC, generated from a limited number of real cases from multiple French centers.
Materials And Methods: A dedicated platform was used by the seven inclusion centers to securely upload their anonymized MRI examinations including all three cross-sectional images (one late arterial and one portal-venous phase T1-weighted images and one fat-saturated T2-weighted image) in compliance with general data protection regulation. The quality of the database was checked by experts and manual delineation of the lesions was performed by the expert radiologists involved in each center.
Purpose: Evaluation of perfusion CT and dual-energy CT (DECT) quantitative parameters for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC) prior to surgery.
Methods: This prospective single-center study included fifty-six patients (44 men; median age 67; range 31-84) who provided written informed consent. Inclusion criteria were (1) treatment-naïve patients with a diagnosis of HCC, (2) an indication for hepatic resection, and (3) available arterial DECT phase and perfusion CT (GE revolution HD-GSI).
Article Synopsis
- A case study of a 34-year-old woman with a multifocal and metastatic epithelioid hemangioendothelioma (HEHE) of the liver shows that traditional chemotherapy worsened her condition, but switching to lenvatinib improved her liver health, leading to a liver transplant six months later.
- Lenvatinib not only helped shrink the tumor, allowing for transplantation, but also effectively managed tumor recurrence eight months post-surgery, demonstrating its potential as a valuable treatment option.
- This case suggests that lenvatinib could be used as a bridging therapy for non-resectable HEHE and may safely integrate with immunosuppressive drugs for patients at high risk of recurrence.
The purpose of this multicenter retrospective study was to assess the MRCP features of Caroli disease (CD). Sixty-six patients were identified from 2000 to 2019. The inclusion criteria were diagnosis of diffuse or localized CD mentioned in an imaging report, presence of intrahepatic bile duct (IHBD) dilatation, and having undergone an MRCP examination.
View Article and Find Full Text PDFBackground & Aims: Despite improvements in medical and surgical techniques, post-hepatectomy liver failure (PHLF) remains the leading cause of postoperative death. High postoperative portal vein pressure (P) and portocaval gradient (PCG), which cannot be predicted by current tools, are the most important determinants of PHLF. Therefore, we aimed to evaluate a digital twin to predict the risk of postoperative portal hypertension (PHT).
View Article and Find Full Text PDFExtrahepatic biliary duplication with heterotopic gastric mucosa in a 46,XX male patient.
Clin Res Hepatol Gastroenterol
June 2020
Extrahepatic biliary duplication is a rare congenital biliary malformation, even more so when associated with heterotopic gastric mucosa. This case report highlights the difficulty of diagnosing such biliary abnormalities, in particular when the duplicated extrahepatic bile duct is the only structure visible by imaging as it is masking the common bile duct. This report shows that extrahepatic bile duct duplication may be a cause of chronic biliary obstruction and secondary sclerosing cholangitis.
View Article and Find Full Text PDFBackground: The clinical significance of discordant radiological and pathological response to preoperative chemotherapy of colorectal liver metastases (CLM) is unknown.
Methods: From 2011 to 2016, all eligible patients undergoing resection for CLM after preoperative chemotherapy were included at two centres. Patients were categorized according to radiologic response using RECIST as Rad-responders (complete/partial response) or Rad-non responders (stable disease) and according to Blazer et al.
Introduction: Intraoperative navigation during liver resection remains difficult and requires high radiologic skills because liver anatomy is complex and patient-specific. Augmented reality (AR) during open liver surgery could be helpful to guide hepatectomies and optimize resection margins but faces many challenges when large parenchymal deformations take place. We aimed to experiment a new vision-based AR to assess its clinical feasibility and anatomical accuracy.
View Article and Find Full Text PDFBackground: Ischemic cholangiopathy (IC) has a known poor prognosis. However, the risks and outcomes of this complication after transcatheter arterial chemoembolization (TACE) in hepatectomized patients are poorly documented. This study aimed to evaluate the incidence of and to identify the predictive factors for IC following TACE for recurrent hepatocellular carcinoma (HCC) after hepatectomy.
View Article and Find Full Text PDFBackground: There are few reports on microvascular invasion (MVI) located intra- or extratumorally and prognosis of hepatocellular carcinoma (HCC).
Objective: The aim of this study was to evaluate patient outcome according to the location of MVI, and to build a nomogram predicting extratumoral MVI.
Methods: We included 681 consecutive patients who underwent hepatic resection (HR) or liver transplantation (LT) for HCC from January 1994 to June 2012, and evaluated patient outcome according to the degree of vascular invasion (VI).
Background & Aims: HIV/HCV co-infected patients with hepatocellular carcinoma (HCC) have poorer survival than HCV mono-infected patients. We aimed to evaluate the prognostic factors for survival.
Methods: From 2006 to 2013, 55 incident HCCs among HIV+/HCV+ patients, from three ANRS cohorts, were compared with 181 HCCs in HIV-/HCV+ patients from the ANRS Cirvir cohort.
Background: Sorafenib is the recommended treatment for patients with advanced hepatocellular carcinoma. We aimed to compare the efficacy and safety of sorafenib to that of selective internal radiotherapy (SIRT) with yttrium-90 (Y) resin microspheres in patients with hepatocellular carcinoma.
Methods: SARAH was a multicentre, open-label, randomised, controlled, investigator-initiated, phase 3 trial done at 25 centres specialising in liver diseases in France.
Hepatic artery stenosis (HAS) is a rare complication of orthotopic liver transplantation (LT). HAS could evolve into complete thrombosis and lead to graft loss, incurring significant morbidity and mortality. Even though endovascular management by percutaneous transluminal angioplasty ± stenting (PTA) is the primary treatment of HAS, its longterm impact on hepatic artery (HA) patency and graft survival remains unclear.
View Article and Find Full Text PDFBackground: In patients receiving preoperative chemotherapy, colorectal liver metastases (CLM) are expected to demonstrate a similar behaviour because of similar organ microenvironment and tumour cell chemosensitivity. We focused on the occurrence of pathological and genetic heterogeneity within CLM.
Methods: Patients resected for multiple CLM between 2004 and 2011 after > three cycles of chemotherapy were included.