O Ernst

University of Lille Nord de France, Lille, Nord-Pas-de-Calais, France

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Publications (123)268.01 Total impact

  • Journal de Chirurgie Viscerale 10/2015; 152(5):A25. DOI:10.1016/S1878-786X(15)30054-1
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    ABSTRACT: The Response Evaluation Criteria in Solid Tumors (RECIST) can have limitations when used to evaluate local treatments for cancer, especially for liver malignancies treated by stereotactic body radiation therapy (SBRT). The aim of this study was to validate the relationship between the occurrence of lobulated enhancement (LE) and local relapse and to evaluate the utility of this relationship for predicting local progression. Imaging data of 59 lesions in 46 patients, including 281 computed tomographic (CT) scans, were retrospectively and blindly reviewed by 3 radiologists. One radiologist measured the lesion size, for each CT and overall, to classify responses using RECIST threshold criteria. The second studied LE occurrence. A third radiologist was later included and studied LE occurrence to evaluate the interobserver consistency for LE evaluation. The mean duration of follow-up was 13.6 months. LE was observed in 16 of 18 progressive lesions, occurring before size-based progression in 50% of cases, and the median delay of LE detection was 3.2 months. The sensitivity of LE to predict progression was 89%, and its specificity was 100%. The positive predictive value was 100%, the negative predictive value was 95.3%, and the overall accuracy was 97%. The probability of local progression-free survival at 12 months was significantly higher for lesions without LE compared with all lesions: 0.80 (CI 95%: 0.65-0.89) versus 0.69 (CI 95%: 0.54-0.80), respectively. The overall concordance rate between the 2 readers of LE was 97.9%. Response assessment of liver metastases treated by SBRT can be improved by including LE. This study demonstrates the diagnostic and predictive utility of LE for assessing local progression at a size still eligible for local salvage treatment. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
    International journal of radiation oncology, biology, physics 06/2015; 13(2). DOI:10.1016/j.ijrobp.2015.01.028 · 4.26 Impact Factor
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    ABSTRACT: Only 20% of patients with colorectal liver metastases are eligible for liver resection, which is the only potentially curative treatment. The main reason for non resectability is related to insufficient volume of the future remnant liver. Several strategies have been proposed to increase the resectability rate: portal vein embolization/ligation and 2-staged liver resection. These strategies are faced with a lack of compensatory hypertrophy or even a risk of tumour progression in the time interval required before resection (2-3 months). In this context, a German team has proposed a new technique of accelerated 2-staged hepatectomy with the acronym "ALPPS" (Score Associating Liver and Portal vein ligation for Staged hepatectomy). This technique consists of, among others, a complete liver partition separating the future remnant liver from the liver to be resected. Important hypertrophy rates are obtained allowing resection in almost all patients. The analysis of the International Registry of ALPPS that included 202 patients helped to better define the indications, with mortality rates below 5% in patients younger than 60 years operated on for colorectal metastases. Oncological benefit remains to be confirmed.

  • Diabetes & Metabolism 03/2015; 41:A83-A84. DOI:10.1016/S1262-3636(15)30314-1 · 3.27 Impact Factor
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    ABSTRACT: Purpose: Most transplant centers use chemoembolisation as locoregional bridge therapy for hepatocellular carcinoma (HCC) before liver transplantation (LT). Chemoembolisation using beads loaded with doxorubicin (DEBDOX) is a promising technique that enables delivery of a large quantity of drugs against HCC. We sought to assess the imaging-histologic correlation after DEBDOX chemoembolisation. Materials and methods: All consecutive patients who had undergone DEBDOX chemoembolisation before receiving liver graft for HCC were included. Tumour response was evaluated according to Response Evaluation Criteria in Solid Tumours (RECIST) and modified RECIST (mRECIST) criteria. The result of final imaging made before LT was correlated with histological data to predict tumour necrosis. Results: Twenty-eight patients underwent 43 DEBDOX procedures for 45 HCC. Therapy had a significant effect as shown by a decrease in the mean size of the largest nodule (p = 0.02) and the sum of viable part of tumour sizes according to mRECIST criteria (p < 0.001). An objective response using mRECIST criteria was significantly correlated with mean tumour necrosis ≥90 % (p = 0.03). A complete response using mRECIST criteria enabled accurate prediction of complete tumour necrosis (p = 0.01). Correlations using RECIST criteria were not significant. Conclusion: Our data confirm the potential benefit of DEBDOX chemoembolisation as bridge therapy before LT, and they provide a rational basis for new studies focusing on recurrence-free survival after LT. Radiologic evaluation according to mRECIST criteria enables accurate prediction of tumour necrosis, whereas RECIST criteria do not.
    CardioVascular and Interventional Radiology 10/2014; 38(3). DOI:10.1007/s00270-014-0967-1 · 2.07 Impact Factor
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    ABSTRACT: A replaced right hepatic artery (RHA) is the most common anatomical variation in pancreatic surgery. The RHA is frequently encountered and can be problematic in pancreatic carcinoma. The preservation of the RHA is necessary to avoid ischemic complications but can impact margins resection in pancreaticoduodenectomy (PD). We report a case of a 53-year-old man with a head pancreatic carcinoma. There was a close contact between the tumor and the RHA arising from superior mesenteric artery (SMA). Preoperative embolization of the RHA was performed prior to PD.
    Journal of gastrointestinal oncology 08/2014; 5(4):E80-3. DOI:10.3978/j.issn.2078-6891.2014.040

  • 04/2014; DOI:10.1530/endoabs.35.OC11.5
  • Paul Borde · Olivier Ernst · Vincent Maunoury ·
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    ABSTRACT: For ten years, a lot of advances have been achieved for the morphological exploration of the small intestine as well as with CT and MR enterography than with wireless capsule endoscopy. These investigations have renewed the approaches of different diseases that can affect the small intestine: tumors, especially sub-mucosal tumors (CT enterography), iron-deficiency anemia (capsule endoscopy) and follow-up of patients with Crohn's disease of the small intestine (MR enterography). Balloon enteroscopy may then allow therapeutic approach when needed (treatment of bleeding angiodysplasia).
    La Revue du praticien 09/2013; 63(7):904-6.
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    ABSTRACT: The objective was to determine the liver volumetric recovering capacity and postoperative course after major hepatectomy in obese patients through a case-matched study. In literature, the impact of obesity on liver recovering has been analyzed only indirectly in terms of morbimortality but never through volumetric assessment. Between 2005 and 2011, 42 patients with body mass index (BMI) 30 or higher (Ob group) underwent major hepatectomy and were matched with 42 patients with BMI 25 or lower (NonOb group) on the magnitude of resection (number of resected segments ±1, remnant liver volume to total liver volume, RLV/TLV, ±5%). The RLV was measured on computed tomographic slices preoperatively and postoperatively at 1 month (RLV-1M) for all patients and within 3 to 12 months in 42 paired patients (median = 6 months, RLV-6M). Considering hepatomegaly in Ob group, RLV was also normalized to body weight (RLVBWR). The liver volumetric gain was expressed as a relative increase [(RLV-1M - RLV)/RLV] or increase in RLVBWR. The Ob and NonOb groups were comparable regarding clinicopathological data, except for arterial hypertension (48% vs 19%; P = 0.005), mean steatosis (24% vs 10%; P = 0.03), and fibrosis incidence (33% vs 10%; P = 0.008). Ob group showed longer operative time and higher blood losses. There were no intergroup differences in liver failure (both 7.1%) and 90-day morbimortality. Despite comparable RLV/TLV (38.1% vs 37.7%; P = 0.13), the relative liver volumetric gain at 1 month was significantly lower in Ob group (+93% vs +115%; P = 0.002), as well as RLVBWR increase (+0.59% vs +0.79%; P < 0.001). The RLV-1M represented 66.2% of initial TLV in Ob group compared with 73.8% (P = 0.005) in NonOb group. This delay in relative volumetric gain persisted at 6 months (+105.4% vs +137.6%; P = 0.009), the RLV-6M representing 71.2% vs 82.4% of initial TLV (P = 0.014). In a methodologically robust trial in the first cohort reported up to date, the regenerative response in obese patients was comparatively slower based on their initial TLV or body weight.
    Annals of surgery 08/2013; 258(5). DOI:10.1097/SLA.0b013e3182a61a22 · 8.33 Impact Factor
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    ABSTRACT: Objectif Le dépistage des surcharges cardiaques en fer se fait habituellement en IRM avec un raccourcissement du T2* myocardique en dessous 20 ms (1,5 T). Cette mesure a été validée avec une séquence spécifique et le logiciel de calcul CMRTools® (technique de référence). Le but de cette étude était de valider l’emploi de séquences et de logiciels disponibles en routine clinique pour dépister ces surcharges. Matériel et méthodes Dans un premier temps, un fantôme de 11 tubes de T2* compris entre 4 à 33 ms a été testé sur trois sites ayant un appareil IRM de marque différente. Dans un second temps, les valeurs du T2* myocardique de 75 patients ont été mesurées en routine clinique par deux méthodes. La première méthode employait la séquence de référence spécialement implantée sur les machines associée au logiciel CMRTools®. La seconde méthode employait les séquences d’acquisitions disponibles en standard sur les machines suivi du calcul sur tableur informatique. Résultats Sur fantôme, la moyenne des différences de T2* entre chaque appareil est de 0,6 ms. Treize patients avaient une valeur abaissée du T2* avec la technique de référence. Trois cas étaient mal classés en technique de routine et correspondaient à des faux-positifs de faible surcharge (T2* compris entre 18–20 ms). Conclusion Le dépistage des surcharges myocardiques en fer peut se faire en IRM en employant des séquences et des logiciels de calcul disponibles en routine clinique pendant le même examen que celui de l’évaluation des surcharges hépatiques en fer.
    06/2013; 94(6):618–625. DOI:10.1016/j.jradio.2013.01.013
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    ABSTRACT: Purpose: Screening for cardiac iron overload is generally done by magnetic resonance imaging (MRI) and demonstrated by a shortening of the myocardial T2* below 20 ms at 1.5 Tesla. This measurement was validated with a specific sequence and the CMRTools(®) calculation software (reference technique). The objective of this study was to validate the use of sequences and software programs that are available in routine clinical practice to screen for iron overload. Material and methods: First, a phantom of 11 tubes with a T2* between 4 and 33 ms was tested at three sites that had MRI machines of different brands. Second, the myocardial T2* values of 75 patients were measured in routine clinical practice using two methods. The first method used the reference sequence specially installed in the machines associated with the CMRTool software. The second method used the standard acquisition sequences available in the machines followed by calculation on a computer spreadsheet. Results: In the phantom, the mean of the differences in T2* between each machine was 0.6 ms. Thirteen patients had a lowered T2* value with the reference technique. Three cases were poorly classified using the routine technique and corresponded with false positives of low overload (T2* between 18 and 20 ms). Conclusion: Screening for myocardial iron overload can be done by MRI by using sequences and calculation software available in routine clinical practice during the same examination as the one for the evaluation of hepatic iron overload.
    Diagnostic and interventional imaging 05/2013; 94(6). DOI:10.1016/j.diii.2013.03.005
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    British Journal of Haematology 05/2013; 162(3). DOI:10.1111/bjh.12368 · 4.71 Impact Factor

  • Medecine Nucleaire 05/2013; 37(5):174. DOI:10.1016/j.mednuc.2013.03.149 · 0.07 Impact Factor

  • 04/2013; DOI:10.1530/endoabs.32.OC6.4
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    ABSTRACT: Objectif L’hématome non traumatique du foie est une pathologie rare compliquant volontiers l’évolution des tumeurs hépatiques. Chez certains patients, l’hémorragie constitue le premier évènement clinique et l’enjeu diagnostique reste entier. Patients et méthodes Cette étude rétrospective s’est déroulée entre juillet 2001 et mars 2011. Les imageries scanner et IRM à la phase aiguë de patients ayant présenté un hématome hépatique inaugural ont été relues, relevant les caractéristiques radio-sémiologiques des hématomes et des lésions hépatiques découvertes, ensuite été confrontées aux diagnostics finals des patients. Résultats Douze patients ont été inclus (âge moyen de 42 ans). Chez sept d’entre eux, une lésion hépatique était visible dès la première imagerie scanographique ou IRM, dont cinq fortement hypervasculaires. Finalement, l’hémorragie a fait découvrir un hépatocarcinome chez quatre patients, un adénome chez deux et une hyperplasie nodulaire focale chez un autre. Conclusion Il est important dans les hémorragies hépatiques spontanées à la phase aiguë de ne pas méconnaître une lésion intrahépatique en réalisant une imagerie injectée suivant un protocole complet. Il faut, dans cette situation particulière où l’hématome est inaugural de la pathologie sous-jacente, envisager une lésion hépatocarcinomateuse même en l’absence d’hépatopathie, et chez les patients jeunes.
    03/2013; 94(3):299–306. DOI:10.1016/j.jradio.2012.06.006
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    ABSTRACT: Background and aims: Anti TNF therapy induces mucosal healing in patients with Crohn's disease, but the effects on transmural inflammation in the ileum are not well understood. Magnetic resonance-enteroclysis (MRE) offers excellent imaging of transmural and peri-enteric lesions in Crohn's ileitis and we aimed to study its responsiveness to anti TNF therapy. Methods: In this multi-center prospective trial, anti TNF naïve patients with ileal Crohn's disease and with increased CRP and contrast enhanced wall thickening received infliximab 5 mg/kg at weeks 0, 2 and 6, and q8 weeks maintenance MRE was performed at baseline, 2 weeks and 6 months and assessed based on a predefined MRE score of severity in ileal Crohn's Disease. Results: Twenty patients were included; of those, 18 patients underwent MRE at week 2 and 15 patients at weeks 2 and 26 as scheduled. Inflammatory components of the MRE index decreased by ≥ 2 points and by ≥ 50% at week 26 (primary endpoint) in 40% and 32% of patients (per protocol and intention to treat analysis, respectively). The MRE index improved in 44% at week 2 and in 80% at week 26. Complete absence of inflammatory lesions was observed in 0/18 at week 2 and 13% (2/15) at week 26. The obstructive elements did not change. Clinical and CRP improvement occurred as early as wk 2, but only CDAI correlated with the MRE index. Conclusion: Improvement of MRE occurs from 2 weeks after infliximab therapy onwards and correlates with clinical response but normalization of MRE is rare.
    Journal of Crohn s and Colitis 02/2013; 7(12). DOI:10.1016/j.crohns.2013.01.011 · 6.23 Impact Factor
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    G Boulouis · C Marmin · S Lemaire · S Boury · G Sergent · S Mordon · O Ernst ·
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    ABSTRACT: Purpose: Although rare, non-traumatic hepatic haemorrhage is a known complication of liver tumors. In cases where the haemorrhage is the first clinical event, diagnostic work-up is critical. Material and methods: This retrospective study was conducted between July 2001 and March 2011. Acute phase CT-scan and MRI imaging in patients diagnosed with non-traumatic liver hematomas were interpreted with particular attention to the radio-semiotic characteristics of hematomas and liver lesions. Those findings were then confronted to the patients' final diagnoses. Results: Twelve patients were included (mean age of 42 years). In seven of them a suspect liver lesion was discovered in the acute CT-Scan or MRI imaging. All lesions were strongly hyper vascular.The haemorrhage revealed hepatocarcinoma in four patients, liver adenoma in two and focal nodular hyperplasia in an other. Conclusion: It is important in spontaneous liver haemorrhage to consider the high probability of hepatocarcinoma or potentially malignant lesions even when the patient has no known hepatic disorders, and especially in young patients. The results of this study show that imaging is a key issue at the acute phase of inaugural non-traumatic hepatic haemorrhages and requires a simple but complete triphasic injected protocol.
    Diagnostic and interventional imaging 01/2013; 94(3). DOI:10.1016/j.diii.2012.09.004
  • F Dubrulle · A Sufana Iancu · C Vincent · G Tourrel · O Ernst ·
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    ABSTRACT: OBJECTIVE: To perform preliminary tests in vitro and with healthy volunteers to determine the 3-T MRI compatibility of a cochlear implant with a non-removable magnet. METHODS: In the in vitro phase, we tested six implants for temperature changes and internal malfunctioning. We measured the demagnetisation of 65 internal magnets with different tilt angles between the implant's magnetic field (bi) and the main magnetic field (b0). In the in vivo phase, we tested 28 operational implants attached to the scalps of volunteers with the head in three different positions. RESULTS: The study did not find significant temperature changes or electronic malfunction in the implants tested in vitro. We found considerable demagnetisation of the cochlear implant magnets in the in vitro and in vivo testing influenced by the position of the magnet in the main magnetic field. We found that if the bi/b0 angle is <90°, there is no demagnetisation; if the bi/b0 angle is >90°, there is demagnetisation in almost 60 % of the cases. When the angle is around 90°, the risk of demagnetisation is low (6.6 %). CONCLUSION: The preliminary results on cochlear implants with non-removable magnets indicate the need to maintain the contraindication of passage through 3-T MRI. KEY POINTS : • Magnetic resonance imaging can affect cochlear implants and vice versa. • Demagnetisation of cochlear implant correlates with the angle between bi and b0. • The position of the head in the MRI influences the demagnetisation. • Three-Tesla MRI for cochlear implants is still contraindicated. • However some future solutions are discussed.
    European Radiology 01/2013; 23(6). DOI:10.1007/s00330-012-2760-3 · 4.01 Impact Factor
  • M. Gomes · C. Leroy · S. Lemaire · C. Marmin · S. Mordon · O. Ernst ·

    Radioprotection 01/2013; 49(1):35-41. DOI:10.1051/radiopro/2013078 · 0.54 Impact Factor
  • C. Marmin · M. Toledano · S. Lemaire · S. Boury · S. Mordon · O. Ernst ·
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    ABSTRACT: Objectifs Comparer les densités des adénomes parathyroïdiens, des ganglions lymphatiques et du parenchyme thyroïdien, lors d’un scanner cervico-thoracique multiphasique pour déterminer les valeurs seuils permettant de les différencier. Patients et méthodes Il s’agit d’une étude portant sur 30 patients opérés d’un adénome parathyroïdien après un examen scanographique réalisé sans injection puis 45 et 70 secondes après injection d’un produit de contraste iodé (350 mgI/mL, 150 mL, 3 mL/s). La mesure de la densité des adénomes, des ganglions lymphatiques et de la thyroïde a été effectuée sur les trois phases (D0, D45, D70). Le rehaussement relatif (RR) à 45 secondes a été calculé : RR = (D45–D0)/D0. Résultats La densité spontanée des adénomes parathyroïdiens est significativement différente de la densité de la thyroïde (p < 0,01) avec une valeur seuil de 75 unités Hounsfield (UH). Le rehaussement après injection des adénomes et des ganglions est significativement différent (p < 0,01). Les adénomes présentent un pic de rehaussement à 45 secondes alors que le rehaussement maximum des ganglions est à 70 secondes. À 45 secondes, une valeur seuil de 114 UH et un RR 125 % permet de les différencier (sensibilité et spécificité 0,96). Conclusion La mesure des densités permet de différencier les adénomes parathyroïdiens, les ganglions lymphatiques et la thyroïde.
    07/2012; 93(s 7–8):632–638. DOI:10.1016/j.jradio.2012.04.004

Publication Stats

2k Citations
268.01 Total Impact Points


  • 2004-2015
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France
  • 1997-2011
    • Centre Hospitalier Régional Universitaire de Lille
      Lille, Nord-Pas-de-Calais, France
  • 2007
    • Groupe Hospitalier Saint Vincent
      Strasburg, Alsace, France
  • 1998
    • Centre Hospitalier Universitaire de Limoges
      Limages, Limousin, France