Philippe Puech

Philippe Puech
Université de Lille · Faculty of Medicine

MD, PhD

About

223
Publications
33,533
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5,265
Citations
Introduction
Working on providing innovative and minimally invasive approaches in the fields of genitourinary oncology ; especially prostate and kidney cancers. I spend my time between the radiology department of the Lille University Hospital, and the Inserm, U703 research lab. I'm involved in medical informatics, too (DicomWorks, Prostate cancer Imaging iPad app,...)
Additional affiliations
November 2006 - present
French Institute of Health and Medical Research
Position
  • Researcher
October 2006 - present
Université de Lille
Position
  • Professor of Radiology
January 1994 - present
Centre Hospitalier Régional Universitaire de Lille
Position
  • Research Assistant
Education
November 2003 - November 2006
Université de Lille
Field of study
  • Biomedical Informatics
November 1997 - November 2001
Claude Bernard University Lyon 1
Field of study
  • Radiology

Publications

Publications (223)
Article
Background The risk of prostate cancer metastatic is correlated with its volume and grade. These parameters are now best estimated preoperatively with magnetic resonance imaging (MRI) and MRI-guided biopsy. Objective To estimate the risk of metastatic recurrence after radical prostatectomy (RP) in our model versus conventional clinical European As...
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Full-text available
Background Data evaluating the impact of positive vascular margins (PVMs) following surgical resection of non-metastatic renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus are lacking.Objective To analyze the oncological impact of positive vascular margins following surgical resection of RCC with IVC tumor thrombus.Methods Pati...
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Background Testicular sperm extraction (TESE) is the method of choice for recovering spermatozoa in patients with azoospermia. However, the lack of reliable biomarkers makes it impossible to predict sperm retrieval outcomes at TESE. To date, little attention has been given to anti-Müllerian hormone (AMH) serum levels in adult men with altered sperm...
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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...
Article
Objectifs L’objectif de cette vidéo est de décrire les différentes étapes chirurgicales d’une néphrectomie droite avec thrombectomie cave (niveau 2) par voie coelio-robotisée. Méthodes Expliquer les différentes étapes chirurgicales en robotique et en particulier le contrôle vasculaire de la veine cave (en toute sécurité). Résultats La durée d’int...
Article
Objectifs L’IRM a une valeur prédictive négative (VPN) de 85 à 95 % pour la détection du cancer de prostate cliniquement significatif (csPCa). Certaines sociétés savantes proposent de ne pas réaliser de biopsies en cas d’IRM non suspecte (IRMn) afin de réduire le diagnostic des cancers indolents (nsPCa). Certains facteurs cliniques ainsi que la den...
Article
Objectifs Les tumeurs vasculaires des voies urinaires sont rares. Les hémangiomes anastomotiques sont une variante de ces tumeurs vasculaires avec une architecture complexe caractérisée par de nombreux vaisseaux anastomosés mais d’aspect bénin. Nous présentons ici le cas d’une patiente de 23 ans avec évolution et manifestation clinique d’un hémangi...
Article
Purpose: Prostate biopsy should be discussed with the patient in case of negative MRI (nMRI) and low clinical suspicious of prostate cancer (PCa). Objectives: Primary objective was to describe the risk of clinically significant PCa (csPCa) in a nMRI biopsy-naïve population at baseline and during long-term follow-up. Secondary objective was to ev...
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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...
Article
Objective: To systematically review the literature on predictive factors for csPCa diagnosis after nMRI in PCa-naïve patients. Evidence acquisition: The Medline and Scopus databases were searched up to March 2019. The review protocol was published in the PROSPERO database (CRD42019125549). The clinical factors and markers studied were age, PSA,...
Article
Objectifs L’IRM à 1,5 T ou 3 T de la prostate est l’imagerie la plus performante pour la détection du cancer de prostate. Nous avons travaillé à des modèles expérimentaux ex vivo d’IRM haute résolution à 7 T permettant d’améliorer la résolution spatiale et la détection tumorale. Méthodes Ce travail a porté sur l’étude en IRM7 T expérimentale (Bruk...
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Full-text available
Purpose To analyse the impact of the presence of extra-target non-clinically significant cancer (NCSC) after high-intensity focused ultrasound (HIFU) hemiablation on oncological results. To analyse radical treatment free survival (RTFS) rates at 2–3 years follow-up. Methods Retrospective single-centre study of 55 patients treated by primary HIFU h...
Article
Objectifs Le reflux vésico-urétéral (rvu) sur transplant rénal peut favoriser les pyélonéphrites aiguës du greffon (pnag) et mettre en péril sa survie. Le traitement de ce rvu par réimplantation chirurgicale ouverte est le gold standard, mais est associé à une morbidité pouvant conduire à la perte du greffon. L’objectif était d’évaluer l’efficacité...
Article
Objectives: To analyze, in patients with prostate cancer (PC) potentially eligible for active surveillance (AS), whether multiparametric-MRI (mp-MRI) predicts presence of clinically significant cancer on radical prostatectomy (RP) specimen. Methods: We identified 77 men with PC eligible for AS (PSA≤15ng/mL, stage≤T2a, Gleason score≤6, up to 3 po...
Article
Aim: To evaluate the contribution of multiparametric MRI (MRI) and targeted biopsies (TB) in the selection and follow-up of patients under active surveillance (AS). Methods: A single-center, retrospective cohort study on 131 patients in AS, with following criteria:≤cT2 stage, PSA≤15ng/mL, Gleason score≤6,≤3 positive biopsies and maximum tumor le...
Article
Objectifs Le traitement optimal des angiomyolipomes (AML) du rein reste débattu. Historiquement, une intervention étaient recommandée lorsque la taille était supérieure à 4 cm. Les deux options thérapeutiques les plus répandues sont la néphrectomie partielle (PN) et l’artério-embolisation sélective (AES). Cependant, les études comparatives sur leur...
Article
Objectifs Évaluer l’apport de l’IRM de prostate avant première série de biopsies. Méthodes Au total, 225 patients adressés pour une première biopsie de prostate (âge ≤ 75 ans, PSA ≤ 20 ng/mL, TR ≤ T2c) ont été inclus dans cette étude prospective multicentrique (16 centres). Après IRM multi-paramétrique, un premier opérateur sans connaissance de l’...
Article
Objectifs Les instillations endovésicales de BCG réduisent le risque de récidive et de progression des TVNIM. En avril 2012, la production de BCG Connaught a été interrompue entraînant une pénurie de BCG en France et une recommandation de limitation de son utilisation par l’AFU. L’objectif de ce travail était d’évaluer les conséquences de cette res...
Article
Objectifs Un tiers des patients atteints de cancer de la prostate localisé ont une lésion index unilatérale qui permettrait un traitement partiel par hémi-ablation HIFU. Cette option alternative aux traitements de la glande entière permet d’éviter ou de diminuer la morbidité fonctionnelle. L’étude AFU a montré 89 % de survie sans traitement de la g...
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Full-text available
Background Secreting interstitial cell (Leydig cell) tumors are rare. In adults, the clinical picture and steroid levels are variable. Case presentation This paper presents a case of left testicular tumor, showing azoospermia with normal serum level of total testosterone, collapsed FSH and LH, and high delta4 androstenedione. Histopathological inv...
Article
Objectifs L’objectif de cette étude était d’évaluer l’apport de l’IRM multiparamétrique comme paramètre à part entière pour prédire la présence de cancer significatif sur pièce de prostatectomie, et donc pour influencer la décision de traitement chez les patients présentant un cancer de prostate potentiellement éligible à une surveillance active (S...
Article
Objectifs La surveillance active (SA) du cancer de prostate de faible risque de progression s’associe à un risque de sous-estimation des tumeurs par les biopsies systématisées (BS) avec un taux de reclassification précoce d’environ 30 %. L’objectif de notre étude était d’évaluer l’apport du couple IRM multiparamétrique (mp) et biopsies dirigées (BD...
Article
Objective: The purpose of the guidelines national committee CCAFU on bladder cancer was to propose updated french guidelines for non-muscle invasive (NMIBC) and invasive (MIBC) bladder cancers. Methods: A Medline search was achieved between 2013 and 2016, as regards diagnosis, options of treatment and follow-up of bladder cancer, to evaluate dif...
Article
Introduction: The purpose was to propose an update of the french guidelines from the national committee CCAFU on upper tract urothelial carcinomas (UTUC). Methods: A systematic Medline search was performed between 2013 and 2016, as regards diagnosis, options of treatment and follow-up of UTUC, to evaluate different references with levels of evid...
Article
Background: Focal ablative therapy may be a suboptimal option for anterior prostate cancers (APCs) reaching the prostate apex due to concerns for thermal injury to the external sphincter. Objective: To explore the technical feasibility of anterior partial prostatectomy (APP) for isolated APCs detected by magnetic resonance imaging (MRI), and to...
Article
Purpose: To obtain an overview of the degree of discrepancy between current clinical practice of prostate magnetic resonance imaging (MRI) in France and recommendations. Materials and methods: A brief survey was sent to 1229 members of the French society of urology in order to identify their indications of prostate MRI and its impact on patient...
Article
For many years, prostate segmentation on MR images concerned only the extraction of the entire gland. Currently, in the focal treatment era, there is a continuously increasing need for the separation of the different parts of the organ. In this paper, we propose an automatic segmentation method based on the use of T2W images and atlas images to seg...
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Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a recently identified renal malignancy. Diagnosis of this rare subtype of renal tumour can be challenging for pathologists, and as such, any additional data would be helpful to improve diagnostic reliability. As imaging features of this new and rare sub-type have not yet been clea...
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Full-text available
Background: Published data on prostate magnetic resonance imaging (MRI) during follow-up of men on active surveillance are lacking. Current guidelines for prostate MRI reporting concentrate on prostate cancer (PCa) detection and staging. A standardised approach to prostate MRI reporting for active surveillance will facilitate the robust collection...
Article
Aortitis are mainly described in inflammatory disorders such as Takayasu arteritis, giant cell arteritis or Behçet's disease. Aortitis is sometimes qualified as idiopathic. However, differential diagnoses must be searched since they need specific interventions. Infectious aortitis should be ruled out first as its rapid evolution and short-term poor...
Article
Objective: To evaluate the practice of immediate postoperative instillation (IPOP) using mitomycin C for non-muscle invasive bladder cancer (NMIBC) treatment by urologists members of the French Association of Urology (AFU). Material and method: Internet-based observational survey evaluating indications and practical modalities of IPOP in NMIBC t...
Article
Objectifs Décrire les pratiques des urologues français en termes de diagnostic, traitement et suivi des tumeurs de vessie n’infiltrant pas le muscle (TVNIM). Évaluer la concordance des pratiques avec les recommandations des associations européenne (EAU) et française d’urologie (AFU). Méthodes Une étude en ligne a été conduite par l’institut de son...
Article
Objectifs Enquête destinée à décrire les pratiques des chirurgiens urologues concernant l’IRM prostatique dans la prise en charge du cancer de prostate. Méthodes Un questionnaire de 15 items a été envoyé par e-mail par l’intermédiaire de l’AFU à ses membres. Cette enquête a été validée conjointement par la Société d’imagerie génito-urinaire et le...
Article
Objective: To review the differences between the BCG strains used for the treatment of non-muscle invasive bladder cancer (NMIBC) at the molecular level, regarding cytotoxicity, immunogenicity, clinical efficiency, and safety. Material and method: A systematic review of the literature search was performed from the database MedLine, focused on th...
Article
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...
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Full-text available
Using a limited temporal resolution dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) dataset to assess the impact of the arterial input function (AIF) choice on the transfer constant (K(trans) ) to distinguish prostate carcinoma (PCa) from benign tissue. Thirty-eight patients with clinically important peripheral PCa (≥0.5 cc) were r...
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Full-text available
Résumé Objectif Analyse de la nécrose tumorale dans notre population générale d’angiomyolipomes (AML) du rein traités de façon préventive par embolisation. Matériels et méthodes Vingt-quatre patients (22 femmes et 2 hommes ; âge moyen : 43 ± 13 ans), soit 30 angiomyolipomes de 137 ± 163 cm³ de volume moyen, ont été embolisés entre 1996 et 2012. D...
Article
The purpose of this study was to retrospectively evaluate tumor necrosis following preventive embolization in patients with renal angiomyolipoma (RAML) at high risk of bleeding. Arterial embolization was performed in 24 patients (22 women, 2 men; mean age, 43±13 years) with a total of 30 RAMLs (mean volume, 137 cm(3)±163) between 1996 and 2012. Two...
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Full-text available
Introduction: Myelolipomas and extramedullary hematopoietic tumors are uncommon benign tumors. They are variably composed of mature adipose tissue and hematopoietic tissue. Myelolipoma is usually observed in the adrenal gland and extramedullary hematopoietic tumors in the liver and spleen but may occasionally be found within solid tumors. Case re...
Article
The current challenge in prostate cancer (PCa) focal therapy indication and planning is how to accurately estimate tumor parameters such as volume, extent and grade. In addition to biopsy results, MRI provides an estimation of PCa contour, volume and histopathological characteristics such as presence of high Gleason grade. Among MRI sequences, diff...
Article
The current selection criteria for Active Surveillance (AS) based on systematic biopsy (SB) underestimate prostate cancer volume and grade. To investigate the role of additional MRI-targeted biopsy (TB) in reclassification of patients who are eligible for AS based on SB. Two-institutions study including 281 men with elevated PSA who met the followi...
Article
The incidence of testicular nodules discovered during infertility evaluation is increasing. These nodules are suspicious of malignancy. There is no paraclinical examination which allows histological orientation to these nodules. The recommendations propose priority treatment by total orchidectomy. Through a retrospective cohort study of infertile p...
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Full-text available
The aim of this study is to provide an automatic framework for computer-aided analysis of multiparametric magnetic resonance (mp-MR) images of prostate. We introduce a novel method for the unsupervised analysis of the images. An evidential C-means classifier was adapted for use with a segmentation scheme to address multisource data and to manage co...
Article
Résumé Objectif Évaluer la survie sans récidive biologique à long terme après prostatectomie totale pour cancer stratifiée, selon la voie d’abord ouverte et laparoscopique avec ou sans assistance robotisée et le stade clinico-pathologique. Matériels et méthodes Étude de suivi de cohorte monocentrique de 1313 patients consécutifs traités par PT po...
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Full-text available
Prebiopsy multiparametric prostate MRI (mp-MRI), followed by transrectal ultrasound-guided (TRUS-G) target biopsies (TB) of the prostate is a key combination for the diagnosis of clinically significant prostate cancers (CSPCa), to avoid prostate cancer (PCa) overtreatment. Several techniques are available for guiding TB to the suspicious mp-MRI ta...
Article
Objective To propose a state of the art regarding imaging techniques for the diagnosis and work-up of upper tract urothelial carcinoma (UTUC). Methods A systematic review of the scientific literature was performed in the Medline database (PubMed) until 2014 using different associations of the following keywords: urothelial carcinomas; upper urinar...
Article
Full-text available
To propose a state of the art regarding imaging techniques for the diagnosis and work-up of upper tract urothelial carcinoma (UTUC).
Article
L’IRM multiparamétrique de la prostate permet de diagnostiquer, avec une grande précision et une excellente valeur prédictive négative, des cancers que les biopsies peinent à détecter. Couplée aux biopsies, elle permet de consolider leur résultat, tant négatif que positif, et de proposer aux patients des modalités de prise en charge plus adaptées (...
Article
Multiparametric MR of the prostate provides an extremely accurate diagnosis and offers an excellent negative predictive value for cancers which biopsies struggle to detect. Combined with biopsies they consolidate both positive and negative biopsy results and allow patients to be offered more appropriate treatments (active monitoring, radical treatm...
Article
The purpose of this study was to assess the roles of MRI-targeted biopsies (TB) and confirmatory biopsies for cancer upstaging at selection in patients considered for active surveillance (AS) for low-risk prostate cancer (PCa) based on the first systematic biopsy (SB) series in another centre. From 2009 to 2012, 41 patients with PCa diagnosed withi...
Article
The current challenge in prostate cancer diagnosis is how to accurately measure the risk of disease progression and guide the treatment decision process between effective intervention for potentially harmful tumors and active surveillance for indolent disease. The issue is how to better identify patients harboring insignificant disease using the cu...
Article
El varicocele corresponde a una dilatación varicosa de las venas del plexo pampiniforme y puede ser responsable de sintomatología como molestias escrotales, hipotrofia testicular o infertilidad masculina. Se explica por la existencia de un reflujo venoso desde el sistema renocava, reflujo que puede objetivarse clínicamente o mediante ecografía dura...
Chapter
Depuis les années 1990, l’IRM est devenue un outil précieux pour guider la prise en charge thérapeutique du cancer de la prostate, en permettant une évaluation de plus en plus précise de l’extension extraprostatique de la tumeur [1, 2]. Depuis le début des années 2000, les perfectionnements techniques ont ouvert l’IRM à des indications beaucoup plu...
Article
L’IRM multiparamétrique de la prostate offre actuellement des performances stables et reproductibles. L’utilité des séquences dynamiques est actuellement débattue, car celles-ci ne font quelquefois que confirmer ce qui a déjà été observé sur l’imagerie de diffusion et nécessitent l’achat d’un produit de contraste. Les supprimer permettrait peut-êtr...
Article
Multiparametric MRI (mp-MRI) of the prostate currently provides stable and reproducible performances. The usefulness of dynamic contrast-enhanced (DCE) sequences is currently challenged, as they sometimes only confirm what has already been observed on diffusion-weighted imaging (DWI) and require the additional purchase of a contrast agent. Eliminat...