Puech P., Randazzo M., Ouzzane A., Gaillard V., Rastinehad A., Lemaitre L., Villers A.   How are we going to train a generation of radiologists (and urologists) to read prostate MRI?.  Curr. Opin. Urol..  2015 ;25 :522-535

PURPOSE OF REVIEW: Multiparametric MRI has gained tremendous importance in the daily practice for patients at risk or diagnosed with prostate cancer. Interpretation of multiparametric-MRI is a complex task, supposedly restricted to experienced radiologists. The purpose of this review is to analyze fundamentals of multiparametric-MRI interpretation and to describe how multiparametric-MRI training could be organized. RECENT FINDINGS: Recently, professional guidelines have been published to provide technical and interpretation frameworks and harmonize multiparametric-MRI practice, but the question of physicians training in prostate multiparametric-MRI reading is still pending. What kind of education, practice, and training makes a radiologist able to reliably interpret a prostate multiparametric-MRI? How can findings be reported to be easily understood? How much experience is needed? How can we train urologists and other physicians to review the examinations they request? Is double-reading necessary? SUMMARY: An institutional-based competency certification process for prostate multiparametric-MRI interpretation may encourage nonspecialized radiologists to qualify for prostate imaging in a standardized and reproducible way, exactly as urologists need it.

van den Bos W., Muller B. G., de Bruin D. M., Abreu A. L. D., Chaussy C., Coleman J. A., Finelli A., Gill I. S., Gross M. E., Jenniskens S. F. M., Kahmann F., Laguna-Pes M. P., Rastinehad A. R., Simmons L. A., Sulser T., Villers A., Ward J. F., de la Rosette Jjmch   Salvage ablative therapy in prostate cancer: International multidisciplinary consensus on trial design.  Urol. Oncol.-Semin. Orig. Investig..  2015 ;33 :495 e1-7

INTRODUCTION: Salvage ablative therapy (SAT) has been developed as a form of localized treatment for localized recurrence of prostate cancers following radiation therapy. To better address the utility of SAT, prospective clinical trials must address the aspects of accepted standards in the initial evaluation, treatment, follow-up, and outcomes in the oncology community. We undertook this study to achieve consensus on uniform standardized trial design for SAT trials. METHODS: A literature search was performed and an international multidisciplinary group of experts was identified. A questionnaire was constructed and sent out to 71 participants in 3 consecutive rounds according to the Delphi method. The project was concluded with a face-to-face meeting in which the results were reviewed and conclusions were formulated. RESULTS: Patients with recurrent disease after radiation therapy were considered candidates for a SAT trial using any ablation scenario performed with cryotherapy or high-intensity focused ultrasound. It is feasible to compare different sources of energy or to compare with historical data on salvage radical prostatectomy outcomes. The primary objective should be to assess the efficacy of the treatment for negative biopsy rate at 12 months. Secondary objectives should include safety parameters and quality-of-life assessment. Exclusion criteria should include evidence of local or distant metastases. The optimal biopsy strategy is image-guided targeted biopsies. Follow-up includes multiparametric magnetic resonance imaging, prostate-specific antigen level, and quality of life for at least 5 years. CONCLUSIONS: A multidisciplinary board from international experts reached consensus on trial design for SAT in prostate cancer and provides a standard for designing a feasible SAT trial.

Mason-Lecomte A., Xylinas E., Colin P., Comperat E., Dubosq F., Houedee N., Larré S., Neuzillet Y., Pignot G., Puech P., Mejean A., Qvick B., Bes P., Rouprêt M.   [Not Available].  Prog. Urol..  2015 ;25 :758
Bauwens J., Azais H., Devouge P., Phalippou J., Boulanger L., Collinet P.   Oncoplastic breast surgery for the management of ductal carcinoma in situ.  Gynecol. Obstet. Fertil..  2015 ;43 :735-739

DCIS (Ductal carcinoma in situ) constitutes 15,2% of breast cancers. Conservative surgery coupled with adjuvant radiotherapy is often recommended. The rate of revision surgery is high, from 30 to 60%. The concern is a high quality resection within clear margins with a satisfactory aesthetic result. The objective of this review is to precise the place of oncoplastic surgery in DCIS care. Among risk factors of recurrence, tumoral invasion of surgical margins is capital. In histology, clear margins usually adopted for DCIS are 2mm, even though there is no international consensus. Recent studies show that a 10mm limit would be better. Aesthetic damage caused by surgery, often increased by radiotherapy, has a negative impact on women quality of life: oncoplastic surgery may minimize it. Techniques of plastic surgery, arranged into level 1 and 2, allow pushing back conservative treatment limits by removing a larger tumor with clear margins. Often used in invasive cancers, few data exist regarding oncoplastic surgery and DCIS. It allows to increase the dimensions of surgical resection by 20% and to decrease positive margins significantly therefore the rate of revision surgeries. Patients are satisfied with it. Specific indications need to be clarified according to age, size and "comedonecrosis" presence. Oncoplastic surgery should be developed in DCIS specific care.

Philandrianos C., Bertrand B., Andrac-Meyer L., Magalon G., Casanova D., Kerfant N., Mordon S.   Treatment of Keloid Scars With a 1210-nm Diode Laser in an Animal Model.  Lasers Surg. Med..  2015 ;47 :798-806

BACKGROUND AND OBJECTIVE: A temperature increase can improve wound healing by activation of heat shock protein 70 and stimulation of fibroblasts. Since keloids are a dysfunction of collagen fiber synthesis and organization, this study aimed to evaluate if a 1,210 nm diode laser could have effects in a new animal model of keloid scars. STUDY DESIGN/MATERIALS AND METHODS: A total of 39 nude mice were used for this study. Phototypes IV and V human keloids were grafted into their backs and after 1 month of healing, the mice were divided into four groups: Control, Laser, Resection, Resection/Laser. In the Laser group, the keloids were treated with a 1,210-nm diode-laser with the following parameters: 4 W; 10 seconds; fluence: 51 J/cm(2) ; spot: 18.9 x 3.7 mm(2) . In the Resection group, surgical intra-lesional excision was performed. In the Resection/Laser group, keloids were treated with the 1,210-nm laser-diode after surgical intra-lesional excision. Temperature measurements were made during the laser treatment. Clinical examination and histological study were performed on the day of treatment and 1 month, 2 months, and 3 months later. RESULTS: Mean temperature measurement was of 44.8 degrees C (42-48 degrees ) in the Laser groups. No healing complications or keloid proliferation was observed in any group. Keloid histologic characters were confirmed in all grafts. No histologic particularity was observed in the laser groups in comparison with the Control and Resection groups. CONCLUSION: First, this keloid animal model appears to be adapted for laser study. Secondly, the 1,210-nm diode laser does not induce keloid thermal damage in vivo. Further studies with different 1,210-nm laser diode parameters should be performed in order to observe significant effects on keloids.

Marchetti P., Guerreschi P., Mortier L., Kluza J.   Integration of Mitochondrial Targeting for Molecular Cancer Therapeutics.  Int J Cell Biol.  2015 ;2015 :283145

Mitochondrial metabolism greatly influences cancer cell survival, invasion, metastasis, and resistance to many anticancer drugs. Furthermore, molecular-targeted therapies (e.g., oncogenic kinase inhibitors) create a dependence of surviving cells on mitochondrial metabolism. For these reasons, inhibition of mitochondrial metabolism represents promising therapeutic pathways in cancer. This review provides an overview of mitochondrial metabolism in cancer and discusses the limitations of mitochondrial inhibition for cancer treatment. Finally, we present preclinical evidence that mitochondrial inhibition could be associated with oncogenic "drivers" inhibitors, which may lead to innovative drug combinations for improving the efficacy of molecular-targeted therapy.

Leroy H. A., Aboukais R., Reyns N., Bourgeois P., Labreuche J., Duhamel A., Lejeune J. P.   Predictors of functional outcomes and recurrence of chronic subdural hematomas.  J. Clin. Neurosci..  2015 ;22 :1895-1900

We aimed to evaluate the functional outcome and risk factors of recurrence in patients operated on for a chronic subdural hematoma (CSH), and discuss systematic early postoperative CT scans. CSH is a very common disease in neurosurgical practice, especially in elderly patients who are treated with anticoagulation. The challenge is to rapidly restore the independence of these patients. We retrospectively analyzed data from 164 consecutive surgical procedures performed on 140 CSH patients, including recurrent surgery, at our institution from June 2011 to June 2012. Pre- and postoperative CT scans, and medical records, were systematically reviewed using the institutional computing database. A poor functional outcome was defined by a modified Rankin scale (mRS) score>2 at 3 months. Among the 140 patients (mean age 76 years; 64% men), a single burr hole craniostomy was performed in 122 patients, and a craniotomy in 18. A poor functional outcome was recorded in 39 patients (28%; 95% confidence interval [CI] 20-35%). In multivariate analyses, an increased risk of poor functional outcome was associated with age >75 years (odds ratio [OR] 5.88; 95% CI 1.96-17.63), residual hematoma thickness >14 mm (OR 3.79; 95% CI 1.47-9.77), and GCS<15 (OR, 2.96; 95% CI, 1.18-7.40). Recurrences occurred in 24 patients (17%; 95% CI 11-23%), with a median delay to reintervention of 13 days. The independent predictors of CSH recurrence were preoperative anticoagulant therapy (OR 3.68; 95% CI 1.13-12.00), and persistence of mass effect on the postoperative CT scan (OR 5.61; 95% CI 1.52-20.66). Three months after surgical treatment, more than one quarter of the CSH patients had a mRS3. The loss of independence was associated with older age, initial GCS<15, and residual hematoma thickness postoperatively. Anticoagulant therapy and persistence of postoperative mass effect heightened the risk of recurrence.

Renard-Penna R., Borgogno C., Puech P., Rouvière O., Mejean A., Rozet F.   [Not Available].  Prog. Urol..  2015 ;25 :829
Vignion-Dewalle A. S., Betrouni N., Tylcz J. B., Vermandel M., Mortier L., Mordon S.   Comparison of three light doses in the photodynamic treatment of actinic keratosis using mathematical modeling.  J. Biomed. Opt..  2015 ;20 :58001

Photodynamic therapy (PDT) is an emerging treatment modality for various diseases, especially for cancer therapy. Although high efficacy is demonstrated for PDT using standardized protocols in nonhyperkeratotic actinic keratoses, alternative light doses expected to increase efficiency, to reduce adverse effects or to expand the use of PDT, are still being evaluated and refined. We propose a comparison of the three most common light doses in the treatment of actinic keratosis with 5-aminolevulinic acid PDT through mathematical modeling. The proposed model is based on an iterative procedure that involves determination of the local fluence rate, updating of the local optical properties, and estimation of the local damage induced by the therapy. This model was applied on a simplified skin sample model including an actinic keratosis lesion, with three different light doses (red light dose, 37 Jcm2, 75 mWcm2, 500 s; blue light dose, 10 Jcm2, 10 mWcm2, 1000 s; and daylight dose, 9000 s). Results analysis shows that the three studied light doses, although all efficient, lead to variable local damage. Defining reference damage enables the nonoptimal parameters for the current light doses to be refined and the treatment to be more suitable.

Vicentini C., Tylcz J. B., Betrouni N., Mortier L., Mordon S.   Is Daylight-PDT a good treatment option during solar eclipse?.  Photodiagnosis Photodyn. Ther..  2015 ;12 :376-377