Olivier Rouvière

Hospices Civils de Lyon (Centre Hospitalier Universitaire de Lyon) | CHU Lyon · Department of Urinary and Vascular imaging

Purpose: The purpose of this study was to develop and test across various scanners a zone-specific region-of-interest (ROI)-based computer-aided diagnosis system (CAD) aimed at characterizing, on MRI, International Society of Urological Pathology (ISUP) grade≥2 prostate cancers. Materials and methods: ROI-based quantitative models were selected...

Objective: To assess PI-RADSv2.1 and PI-RADSv2 descriptors across readers with varying experience. Methods: Twenty-one radiologists (7 experienced (≥ 5 years) seniors, 7 less experienced seniors and 7 juniors) assessed 240 'predefined' lesions from 159 pre-biopsy multiparametric prostate MRIs. They specified their location (peripheral, transitio...

In light of recent prostate cancer screening programme proposed by the European Association of Urology, there is an urgent need to optimise detection of clinically significant cancer while minimising overdiagnosis. This may be achieved by omitting systematic biopsies while ensuring quality control for diagnostic magnetic resonance imaging and targe...

Objectives We evaluated the contribution of lung lesion quantification on chest CT using a clinical Artificial Intelligence (AI) software in predicting death and intensive care units (ICU) admission for COVID-19 patients. Methods For 349 patients with positive COVID-19-PCR test that underwent a chest CT scan at admittance or during hospitalization...

Purpose: The purpose of this study was to perform a systematic review of the literature on the diagnostic performance, in independent test cohorts, of artificial intelligence (AI)-based algorithms aimed at characterizing/detecting prostate cancer on magnetic resonance imaging (MRI). Materials and methods: Medline, Embase and Web of Science were...

Multiparametric magnetic resonance imaging (mp-MRI) has shown excellent results in the detection of prostate cancer (PCa). However, characterizing prostate lesions aggressiveness in mp-MRI sequences is impossible in clinical practice, and biopsy remains the reference to determine the Gleason score (GS). In this work, we propose a novel end-to-end m...

Multiparametric magnetic resonance imaging (mpMRI) has high sensitivity but low specificity for prostate cancer (PCa) diagnosis. The aim of our systematic review was to investigate the proportion of PCa found at a repeat biopsy in patients with a negative initial prostate biopsy, despite initial positive mpMRI. Included patients had a Prostate Imag...

Résumé Bien que l’IRM se soit imposée dans le diagnostic précoce du cancer de prostate, ses performances restent limitées par sa faible spécificité et sa variabilité interlecteur substantielle. Les progrès récents des techniques d’Intelligence Artificielle en imagerie médicale font espérer que l’analyse automatique des IRM de prostate puisse amélio...

Purpose/Objective(s) Stereotactic body radiotherapy (SBRT) has become a new therapeutic option for primary renal cell carcinoma. However, treatment doses lack consistency in the literature. The primary objective of this study was to determine the maximum tolerated dose for renal cancer SBRT. Materials/Methods This phase I multicentric dose-escalat...

Purpose: The purpose of this study was to quantify the influence of factors of variability on apparent diffusion coefficient (ADC) estimation in the normal prostate peripheral zone (PZ). Materials and methods: Fifty healthy volunteers underwent in 2017 (n = 17) or 2020 (n = 33) two-point (0, 800 s/mm²) prostate diffusion-weighted imaging in the...

Background: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is useful for selected clinical indications in patients with prostate cancer (PCa) but it may have broader clinical utility owing to the emergence of lutetium-177-PSMA-617 ([177Lu]Lu-PSMA) therapy. However, robust data regarding the im...

Résumé Introduction Depuis 2019, il est recommandé de réaliser une IRM multiparamétrique prostatique avant toute biopsie. Messages principaux Cette IRM doit comprendre une imagerie T2, une imagerie de diffusion et une imagerie dynamique après injection. L’imagerie T2 doit être acquise dans au moins deux plans orthogonaux. L’imagerie de diffusion...

Active surveillance (AS) is the recommended treatment option for low-risk and favourable intermediate-risk prostate cancer management, preserving oncological and functional outcomes. However, active monitoring using relevant parameters in addition to the usual clinical, biological and pathological considerations is necessary to compensate for initi...

Background: Reverse anterolateral thigh perforator (ALTp) pedicle flap can be used to reconstruct perigenicular defect thanks to the anastomoses between the descending branch of the lateral circumflex femoral artery (LCFA) and the perigenicular network. In a few cases, however, patients do not present any ALTp. We hypothesized that, in such cases,...

Key points: • Before a prostate biopsy, the likely benefits and the harms emanating from true and false test MRI results need to be balanced. Prioritizing patients' preferences and their tolerance to potential harms are essential to assess.• The decision curve analysis method is an analytical framework where the net clinical benefit is plotted aga...

Introduction Prostate multiparametric MRI (mpMRI) has shown good sensitivity in detecting cancers with an International Society of Urological Pathology (ISUP) grade of ≥2. However, it lacks specificity, and its inter-reader reproducibility remains moderate. Biomarkers, such as the Prostate Health Index (PHI), may help select patients for prostate b...

New imaging techniques are more sensitive in prostate cancer and reveal sites of disease that may never have been seen with conventional imaging, resulting in stage migration and potentially a change in the clinical management. Until long-term data provide a better understanding of the natural history of the disease defined by more sensitive imagin...

Résumé La consultation de radiologie interventionnelle fait partie du parcours de soins du patient en radiologie interventionnelle. Sa conduite et son organisation obéissent à des recommandations présentées dans cet article et reprenant les points suivants : qui la réalise ; comment informe-t-on le patient ; comment doivent être organisés les locau...

Multiparametric magnetic resonance imaging (mp-MRI) has shown excellent results in the detection of prostate cancer (PCa). However, characterizing prostate lesions aggressiveness in mp-MRI sequences is impossible in clinical practice, and biopsy remains the reference to determine the Gleason score (GS). In this work, we propose a novel end-to-end m...

Take Home Message New imaging techniques (including MRI and PET with performant tracers) are more sensitive in prostate cancer than conventional imaging and reveal sites of disease that may never have been seen with conventional imaging; resulting in stage migration and potentially a change in the clinical management. Until such time that long-term...

Purpose Carotid artery stenting (CAS) appears as a promising alternative treatment to carotid endarterectomy for radiation therapy (RT)-induced carotid stenosis. However, this is based on a poor level of evidence studies (small sample size, primarily single institution reports, few long-term data). The purpose of this study was to report the long-t...

Objective: To train and to test for prostate zonal segmentation an existing algorithm already trained for whole-gland segmentation. Methods: The algorithm, combining model-based and deep learning-based approaches, was trained for zonal segmentation using the NCI-ISBI-2013 dataset and 70 T2-weighted datasets acquired at an academic centre. Test d...

Context There is uncertainty regarding the most appropriate criteria for recruitment, monitoring, and reclassification in active surveillance (AS) protocols for localised prostate cancer (PCa). Objective To perform a qualitative systematic review (SR) to issue recommendations regarding inclusion of intermediate-risk disease, biopsy characteristics...

Objectifs La récidive locale après chirurgie puis radiothérapie (adjuvante ou de rattrapage) est une situation problématique et identifiée de plus en plus souvent grâce au PET scanner (choline ou PSMA). Peu de données sont disponibles sur les options de traitements de rattrapage. Méthodes Nous avons étudié rétrospectivement les patients traités pa...

Objectifs Présentation des résultats fonctionnels et oncologiques à long termes des HIFU de rattrapage des récidives locales après radiothérapie. Méthodes Il s’agit d’une étude de phase IIb de cohorte multicentrique et prospective conduite en France et en Norvège. Le traitement HIFU de rattrapage était réalisé après récidive locale après radiothér...

Objective: The most commonly used dose for prostate cancer stereotactic body radiotherapy (SBRT) is 5 × 7.25 Gy. The aim of this study was to evaluate the dosimetric feasibility of a 5 × 9 Gy SBRT regimen while still limiting the dose to the urethra to 5 × 7.25 Gy. This dosimetric study is part of the groundwork for a future Phase III randomized t...

Context Surgical techniques aimed at preserving the neurovascular bundles during radical prostatectomy (RP) have been proposed to improve functional outcomes. However, it remains unclear if nerve-sparing (NS) surgery adversely affects oncological metrics. Objective To explore the oncological safety of NS versus non-NS (NNS) surgery and to identify...

Background: To develop an international, multi-site nomogram for side-specific prediction of extraprostatic extension (EPE) of prostate cancer based on clinical, biopsy, and magnetic resonance imaging- (MRI) derived data. Methods: Ten institutions from the USA and Europe contributed clinical and side-specific biopsy and MRI variables of consecut...

Artificial intelligence developments are essential to the successful deployment of community-wide, MRI-driven prostate cancer diagnosis. AI systems should ensure that the main benefits of biopsy avoidance are delivered while maintaining consistent high specificities, at a range of disease prevalences. Since all current artificial intelligence / com...

Context: While urinary incontinence (UI) commonly occurs after radical prostatectomy (RP), it is unclear what factors increase the risk of UI development. Objective: To perform a systematic review of patient- and tumour-related prognostic factors for post-RP UI. The primary outcome was UI within 3 mo after RP. Secondary outcomes included UI at 3–12...

Context: The impact of surgeon and hospital volume on outcomes after radical prosta�tectomy (RP) for localised prostate cancer (PCa) remains unknown. Objective: To perform a systematic review on the association between surgeon or hospital volume and oncological and nononcological outcomes following RP for PCa. Evidence acquisition: Medline, Medline...

Objectives: To report the preliminary results of salvage high-intensity focused ultrasound for locally recurrent prostate cancer in the prostatic bed after radical prostatectomy and adjuvant or salvage radiotherapy. Materials & methods: We retrospectively analyzed a single-center cohort of men treated with salvage high-intensity focused ultrasou...

In the prospective multicenter Prostate Evaluation for Clinically Important Disease: Sampling Using Image-Guidance or Not? (PRECISION) trial,¹ 500 biopsy-naive patients with suspected prostate cancer were randomly assigned to either classical 10- to 12-core systematic biopsy or to magnetic resonance imaging (MRI) and targeted biopsy without systema...

PurposeProstate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is used for (re)staging prostate cancer (PCa) and as a biomarker for evaluating response to therapy, but lacks established response criteria. A panel of PCa experts in nuclear medicine, radiology, and/or urology met on February 21, 2020, in...

Context The clinical effectiveness of focal therapy (FT) for localised prostate cancer (PCa) remains controversial. Objective To analyse the evidence base for primary FT for localised PCa via a systematic review (SR) to formulate clinical practice recommendations. Evidence acquisition A protocol-driven, PRISMA-adhering SR comparing primary FT (su...

Objective To analyse the evidence base for primary FT for localised PCa via a systematic review (SR) to formulate clinical practice recommendations. Evidence acquisition A protocol-driven, PRISMA-adhering SR comparing primary FT (sub-total, focal, hemi-gland, or partial ablation) versus standard options (active surveillance [AS], radical prostatect...

A systematic review of focal ablative therapy for clinically localised prostate cancer in comparison with standard management options: Limitations of the available evidence and recommendations for clinical practice and further research

Objective To present a summary of the 2020 version of the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on screening, diagnosis, and local treatm...

Objectifs Évaluer les résultats préliminaires du traitement par HIFU de sauvetage chez les patients présentant une récidive locale d’un cancer de prostate (CaP) dans la loge de prostatectomie après chirurgie puis radiothérapie adjuvante ou de rattrapage. Méthodes De juillet 2009 à novembre 2018, tous les patients traités par HIFU pour une récidive...

Background The precise origin of phosphate that is removed during hemodialysis remains unclear; only a minority comes from the extracellular space. One possibility is that the remaining phosphate originates from the intracellular compartment, but there have been no available data from direct assessment of intracellular phosphate in patients undergo...

Objective To present a summary of the 2020 version of the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy & Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Geriatric Oncology (SIOG) guidelines on the treatment of relapsing, metastatic,...

Introduction Pelvic lymphocele is the most common complication of pelvic lymph node dissection after radical prostatectomy. Management of symptomatic pelvic lymphocele begins with percutaneous drainage, followed by sclerotherapy or surgical marsupialization and more recently, lymphatic embolization. In this article, we show the feasibility and resu...

Objectives To assess the diagnostic performances of chest CT for triage of patients in multiple emergency departments during COVID-19 epidemic, in comparison with reverse transcription polymerase chain reaction (RT-PCR) test.Method From March 3 to April 4, 2020, 694 consecutive patients from three emergency departments of a large university hospita...

Purpose To assess the feasibility and tumor outcome of re-irradiation with low-dose-rate brachytherapy for macroscopic local recurrences after radical prostatectomy (RP) followed by adjuvant or salvage external beam radiation therapy (EBRT). Methods and Materials Between 2011 and 2018, five men with histologically proven local failure within the p...

In order to understand which management plan is appropriate for an individual patient, we must first understand the stage and grade of their disease to allow instigation of the most effective intervention and avoid side effects from unnecessary treatments. However, investigations come with risks and costs that can only be justified if they change t...

The original version of this article, published on 02 May 2020, unfortunately contained a mistake.

Purpose The purpose of this study was to assess the predictors of metastasis-free survival (MFS) and of the volume of the local recurrence in patients with rising prostate-specific antigen (PSA) serum level after radiotherapy for prostate cancer and referred for prostate magnetic resonance imaging (MRI) and biopsy in view of salvage treatment. Mat...

Objectives This study aims to define consensus-based criteria for acquiring and reporting prostate MRI and establishing prerequisites for image quality.MethodsA total of 44 leading urologists and urogenital radiologists who are experts in prostate cancer imaging from the European Society of Urogenital Radiology (ESUR) and EAU Section of Urologic Im...

As COVID-19 spreads around the world, it causes an influx in the emergency departments of the hospitals. In this context, quick triage of patients towards the COVID+ and COVID- hospital units is essential. In our large university hospital in Lyon, we opted to carry out chest CT scans as well as virological tests (RT-PCR) in any patient from the thr...

Objectives To establish national reference levels (RLs) in interventional procedures under CT guidance as required by the 2013/59/Euratom European Directive.Methods Seventeen categories of interventional procedures in thoracic, abdominopelvic, and osteoarticular specialties (percutaneous infiltration, vertebroplasty, biopsy, drainage, tumor destruc...

EAU Prostate cancer guidelines

Context: The optimal treatment for men with high-risk localized or locally advanced prostate cancer (PCa) remains unknown. Objective: To perform a systematic review of the existing literature on the effectiveness of the different primary treatment modalities for high-risk localized and locally advanced PCa. The primary oncological outcome is the...

Purpose To prospectively compare the diagnostic capabilities of computed tomography angiography (CTA) to those of digital subtraction angiography (DSA) in endurance athletes with suspicion of arterial endofibrosis. Materials and methods Forty-five athletes (39 men, 6 women; median age: 30 years, interquartile range: 23–42 years) prospectively unde...

Objectives: To develop technical guidelines for magnetic resonance imaging aimed at characterising renal masses (multiparametric magnetic resonance imaging, mpMRI) and at imaging the bladder and upper urinary tract (magnetic resonance urography, MRU). Methods: The French Society of Genitourinary Imaging organised a Delphi consensus conference wi...

BACKGROUND: Measurement of ankle and brachial blood pressure after maximal exercise is largely used to diagnose exercise-induced arterial endofibrosis (EIAE). AIMS AND OBJECTIVES: We aimed to compare the different available methods and combination of these and propose a method based on graphical interpretation, for the diagnosis of EIAE. MATERIAL...

Objectives To develop technical guidelines for computed tomography urography. Methods The French Society of Genitourinary Imaging organised a Delphi consensus conference with a two-round Delphi survey followed by a face-to-face meeting. Consensus was strictly defined using a priori criteria. Results Forty-two expert uro-radiologists completed bot...

Background: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. Objective: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. Desi...

Background: The use of a magnetic resonance imaging (MRI)-directed diagnostic pathway in men at first prostate cancer work-up has been introduced within European prostate cancer guidelines. Differences in MRI-directed pathway yields need elaboration. Objective: To investigate the diagnostic yields of MRI-directed diagnostic pathways in biopsy-na...

Background: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. Objective: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. Desi...

Background: There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised. Objective: To develop consensus statements for all domains of DAT. Design, setting, and participants: A protocol-driven, three phase study was...

Introduction et but de l’étude Il s’agissait d’un étude de la faisabilité d’une réirradiation par une technique de curiethérapie des récidives locales dans la loge de prostato-vésiculectomie. Matériel et méthodes Entre janvier 1991 et septembre 2018, cinq patients ont eu une curiethérapie de rattrapage après prostatectomie suivie d’une radiothérap...

No PDF available ABSTRACT Clinical devices that give elastography imaging from a shear wave speed measurement within tissues uses controlled sources for elastic wave generation. It can be a mechanical vibrator for transient elastography and magnetic resonance elastography (MRE) or ultrasound radiation pressure for ARFI and shear wave elastography t...

Clinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related factors and inadequate clinic-BP measurement. We investigated whether nonadherence to antihypertensive medications may also influence this difference in a post hoc analysis of the DENERHTN trial (Renal Denervation for Hypertension). We pooled the data of...

Purpose: To assess the performance of a computer-aided diagnosis (CADx) system trained at characterizing International Society of Urological Pathology (ISUP) grade≥2 peripheral zone (PZ) prostate cancers on multiparametric magnetic resonance imaging (mpMRI) examinations from a different institution and acquired on different scanners than those use...