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Clinical characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital

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Cancer Biology & Medicine 2020年第1期17卷 199-207页

作者： Xiaonan Cui Daiwei Han Marjolein AHeuvelmans Yihui Du Yingru Zhao Lei Zhang Harry JMGroen Geertruida Hde Bock Monique DDorrius matth.js oudkerk Rozemarijn Vliegenthart Zhaoxiang Ye Department of Radiology Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin's Clinical Research Center for CancerTianjin 300060China Department of Radiology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Department of Epidemiology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Medisch Spectrum Twente Department of PulmonologyEnschede 7512 KZThe Netherlands Department of Thoracic Surgery Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin’s Clinical Research Center for CancerTianjin 300060China Department of Pulmonary Diseases University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands University of Groningen University Medical Center GroningenGroningen 9713 GZThe Netherlands

Objectives:To evaluate the characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer ***:Patients with pulmonary nodules 4–25 mm in diameter detected via computed tomography(CT)in 2013 were consecutively *** analysis was restricted to patients with a histological nodule diagnosis or a 2-year follow-up period without nodule growth confirming benign *** information was collected from hospital ***:Among the 314 nodules examined in 299 patients,212(67.5%)nodules in 206(68.9%)patients were *** to benign nodules,malignant nodules were larger(18.0 mm vs.12.5 mm,P<0.001),more often partly solid(16.0%vs.4.7%,P<0.001)and more often spiculated(72.2%vs.41.2%,P<0.001),with higher density in contrast-enhanced CT(67.0 HU vs.57.5 HU,P=0.015).Final diagnosis was based on surgery in 232 out of 314(73.9%)nodules,166 of which were identified as malignant[30(18.1%)stage III or IV]and 66 as *** 36 nodules(11.5%),diagnosis was confirmed by biopsy and the remainder verified based on stability of nodule size at follow-up imaging(n=46,14.6%).Among 65 nodules subjected to gene(EGFR)mutation analyses,28(43.1%)cases(EGFR19 n=13;EGFR21 n=15)were identified as EGFR mutant and 37(56.9%)as EGFR *** to surgery,the majority of patients[n=194(83.6%)]received a contrast-enhanced CT scan for staging of both malignant[n=140(84.3%)]and benign[n=54(81.8%)]*** of positron emission tomography(PET)-CT was relatively uncommon[n=38(16.4%)].Conclusions:CT-derived nodule assessment assists in diagnosis of small to intermediate-sized malignant pulmonary ***,contrast-enhanced CT is commonly used as the sole diagnostic confirmation technique for pre-surgical staging,often resulting in surgery for late-stage disease and unnecessary surgery in cases of benign nodules.

关键词： Lung nodule diagnosis computed tomography pathology China

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Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI

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World Journal of Gastroenterology 2006年第11期12卷 1699-1705页

作者： Christoph F Dietrich Wolfgang Kratzer Deike Strobel Etienne Danse Robert Fessl Alfred Bunk Udo Vossas Karlheinz Hauenstein Wilhelm Koch Wolfgang Blank matth.js oudkerk Dietbert Hahn Christian Greis Department of Internal Medicine Ⅱ Johann Wolfgang Goethe University Hospital 60590 FrankfurtGermany Department of Internal Medicine Ⅰ University Hospital Ulm 89070Germany Medical Clinic Ⅰ University Hospital Erlangen 91054Germany Department of Radiology University Hospital St.Luc Brussels 1200Belgium Department of Radiology Central Hospital Augsburg 86156Germany Department for Visceral Thoracic and Vascular Surgery University HospitalDresden 01307Germany Department of Radiology Marien Hospital DUsseldorf 40479Germany Department of Radiology University Hospital Rostock 18055Germany Medical Clinic Ⅱ Leopoldina Hospital Schweinfurt 97422Germany Department of Internal Medicine Hospital am Steinenberg Reutlingen 72764Germany Department of Radiology University Hospital Groningen 9700Netherlands Department of Radiology University Hospital Würzburg 97080Germany Clinical Research Bracco Altana Pharma Konstanz 78467Germany

AIM： To evaluate contrast-enhanced ultrasonography （CEUS） using SonoVue in the detection of liver metastases in patients with known extrahepatic primary tumors versus the combined gold standard comprising CT, MRI and clinical/histological data. METHODS： It is an international multicenter study, and there were 12 centres and 125 patients （64 males, 61 females, aged 59 ± 11 years） involved, with 102 patients per protocol. Primary tumors were colorectal in 35%, breast in 27%, pancreatic in 17% and others in 21%. CEUS using SonoVue was employed with a Iow-mechanical-index technique and contrast-specific software using Siemens Elegra, Philips HDI 5000 and Acuson Sequoia; continuous scanning for at least five minutes. RESULTS： CEUS with SonoVue increased significantly the number of focal liver lesions detected versus unenhanced sonography. In 31.4% of the patients, more lesions were found after contrast enhancement. The total numbers of lesions detected were comparable with CEUS （55）, triple-phase spiral CT （61） and HRI with a liverspecific contrast agent （53）. Accuracy of detection of metastatic disease （i.e. at least one metastatic lesion） was significantly higher for CEUS （91.2%） than for unenhanced sonography （81.4%） and was similar to that of triple-phase spiral CT （89.2 %）. In 53 patients whose CEUS examination was negative, a follow-up examination 3-6 months later confirmed the absence of metastatic lesions in 50 patients （94.4%）. CONCLUSION： CEUS is proved to be reliable in the detection of liver metastases in patients with known extrahepatic primary tumors and suspected liver lesions.

关键词： CT MRI Metastasis Detection SonoVue

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Methods of computed tomography screening and management of lung cancer in Tianjin: design of a population-based cohort study

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Cancer Biology & Medicine 2019年第1期16卷 181-188页

作者： Yihui Du Yingru Zhao Grigory Sidorenkov Geertruida H.de Bock Xiaonan Cui Yubei Huang Monique D.Dorrius Mieneke Rook Harry J.M.Groen Marjolein A.Heuvelmans Rozemarijn Vliegenthart Kexin Chen Xueqian Xie Shiyuan Liu matth.js oudkerk Zhaoxiang Ye Department of Epidemiology University of Groningen University Medical Center Groningen Center for Medical Imaging-North East Netherlands University of Groningen University Medical Center Groningen Department of Radiology Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin’s Clinical Research Center for Cancer Department of Epidemiology and Biostatistics Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin’s Clinical Research Center for Cancer Department of Radiology University of Groningen University Medical Center Groningen Department of Radiology Martini Hospital Department of Pulmonary Diseases University of Groningen University Medical Centre Groningen Medisch Spectrum Twente Department of Pulmonology Department of Radiology Shanghai General HospitalShanghai Jiao Tong University School of Medicine Department of Radiology Shanghai Changzheng Hospital The Second Military Medical University Shanghai

Objective: European lung cancer screening studies using computed tomography(CT) have shown that a management protocol based on measuring lung nodule volume and volume doubling time(VDT) is more specific for early lung cancer detection than a diameter-based protocol. However, whether this also applies to a Chinese population is unclear. The aim of this study is to compare the diagnostic performance of a volume-based protocol with a diameter-based protocol for lung cancer detection and optimize the nodule management criteria for a Chinese ***: This study has a population-based, prospective cohort design and includes 4000 participants from the Hexi district of Tianjin, China. Participants will undergo low-dose chest CT at baseline and after 1 year. Initially, detected lung nodules will be evaluated for diameter and managed according to a routine diameter-based protocol(Clinical Practice Guideline in Oncology for Lung Cancer Screening, Version 2.2018). Subsequently, lung nodules will be evaluated for volume and management will be simulated according to a volume-based protocol and VDT(a European lung nodule management protocol). Participants will be followed up for 4 years to evaluate lung cancer incidence and mortality. The primary outcome is the diagnostic performance of the European volume-based protocol compared to diameter-based management regarding lung nodules detected using low-dose ***: The diagnostic performance of volume-and diameter-based management for lung nodules in a Chinese population will be estimated and ***: Through the study, we expect to improve the management of lung nodules and early detection of lung cancer in Chinese populations.

关键词： Lung cancer lung nodules screening computed tomography China

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在临床研究中免费DICOM去识别工具:病人隐私的功能与安全

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国际医学放射学杂志 2016年第1期 101-102页

作者： K.Y.E.Aryanto M.oudkerk P.M.A.van Ooijen 梁静 University of Groningen University Medical Center GroningenCenter for Medical Imaging - North East Netherlands (CMI-NEN)Department of Radiology

摘要目的为了比较非商业DICOM工具包从DICOM页眉中去识别出病人个人健康信息的能力。材料与方法选择10个DICOM工具包用于去识别测试。这个测试使用的是系统默认的去识别卡,随后,这些工具的设置被调整到最佳状态。研究目的是消除病人身... 详细信息

摘要目的为了比较非商业DICOM工具包从DICOM页眉中去识别出病人个人健康信息的能力。材料与方法选择10个DICOM工具包用于去识别测试。这个测试使用的是系统默认的去识别卡,随后,这些工具的设置被调整到最佳状态。研究目的是消除病人身份识别信息的50个元素。同时检测这些工具包各自专门的定制方法。结果仅其中一个工具包能够去识别所有默认设置的元素。不是所有的工具包都能提供了一个可定制的去识别卡。6个工具包可以改变,通

关键词： DICOM 所有个人健康信息工具包病人

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b值及预先使用对比剂对1.5T乳腺DWI诊断准确性的影响:系统回顾及荟萃分析

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国际医学放射学杂志 2015年第1期 87-88页

作者： M.D.Dorrius H.Dijkstra P.E.Sijens M.oudkerk Department of Radiology EB44University of Groningen/University Medical Center GroningenCenter for Medical Imaging North East NetherlandsUniversity of Groningen

目的评估b值的选择及预先使用对比剂对乳腺疾病扩散加权成像(DWI)表观扩散系数(ADC)的影响,以及在良恶性病变鉴别中的作用。方法查找DWI研究相关文

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软件包的选择对半定量MR心肌灌注分析结果的影响

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国际医学放射学杂志 2013年第3期 263-264页

作者： A.Handayani P.E.Sijens D.D.Lubbers P.Triadyaksa M.oudkerk P.M.van Ooijen 钟垚莹 Center for Medical Imaging North East Netherlands University of Groningenand Department of RadiologyUniversity Medical Center

目的评估不同软件包对半定量MR灌注分析的可重复性和再现性。材料与方法该研究方案获得机构伦理委员会批准。每例病人均签署知情同意书。半定量灌注分析共2次,由2名独立观察者用4种专用软件包处理。MR灌注数据来自于8例冠状动脉成像已... 详细信息

目的评估不同软件包对半定量MR灌注分析的可重复性和再现性。材料与方法该研究方案获得机构伦理委员会批准。每例病人均签署知情同意书。半定量灌注分析共2次,由2名独立观察者用4种专用软件包处理。MR灌注数据来自于8例冠状动脉成像已确定为单支冠状动脉病变的病人,并已经被安排进行经皮冠状动脉介入(PCI)治疗。每例病人都接受了2次检查:PCI术前1d和术后1d。用Studentt检验和Bland-Altman分析评估灌注上升斜率、心肌灌注储备指数的可重复性(观察者内部及观察者之间达成一致)和再现性(软件之间达成一致)。结果在每个单独的软件平台上反复测量能在观察者内部及观察者之间形成好的、可比较的一致性[平均差异<6%,组内相关系数(ICC)≥0.68]。然而,软件之间的结果比较有显著性变异,以致不同的软件包产生的值是不可互换的(一致性的限度≥65%,ICC≤0.67)。结论结果表明,在单一软件中具有高重复性,但不同软件包间却显示低再现性。这个现象表明半定量灌注参数的组内和(或)序贯观测必须在同一个软件平台下。在半定量灌注分析被真正纳入临床研究前,解决软件包之间的差异是非常重要的。

关键词：半定量再现性复现性 MR 心肌灌注软件工程软件包

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胸部CT对弥漫性特发性骨肥厚的诊断:观察者间一致性

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国际医学放射学杂志 2017年第2期 230-231页

作者： S.F.oudkerk P.A.de Jong M.Attrach T.Luijkx C.F.Buckens W.P.T.M.Mali 杜倩妮 Department of Radiology and Nuclear Medicine University Medical Center Utrecht

摘要目的评估和改善基于CT对弥漫性特发性骨肥厚(DISH)诊断观察者间的一致性。方法将600例接受CT检查行肺癌筛查的病人随机分为2组。根据Resnick对X线表

关键词：弥漫性特发性骨肥厚病人胸部躯干 CT

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早期弥漫性特发性骨质增生症诊断标准的制定与验证

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国际医学放射学杂志 2019年第4期 481-481页

作者：高天阳 J.S.Kuperus S.F.oudkerk W.Foppen F.A.M.Hoesein W.P.Gielis J.Waalwijk Department of Orthopedic Surgery University Medical Center Utrecht

摘要弥漫性特发性骨质增生(DISH)是一种以4个相邻椎体沿脊柱前外侧形成新骨为特征的疾病。目的对来自2个大规模回顾性队列的CT数据提出DISH早期阶段的标准

关键词：弥漫性特发性骨质增生症相邻节段

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慢性阻塞性肺疾病CT形态测量与气道阻塞关系的系统回顾和Meta分析

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国际医学放射学杂志 2012年第6期 605-605页

作者： P.A.de Jong M.oudkerk N.H.T.ten Hacken 陶英伟 Center for Medical Imaging-North East Netherlands(CMI-NEN) Department of RadiologyUniversity of GroningenUniversity Medical Center GroningenHanzeplein 1P.O.Box 0019700RBGroningenThe Netherlands

目的确定肺气肿或外周气道的CT测量与慢性阻塞性肺疾病(COPD)气道阻塞之间的相关性。方法检索1976—2011年PubMed、Embase和Web of Knowledge数据库。两名独立研究者通过筛选1763篇有关应用CT测量慢性阻塞性肺病病人肺功能测试的气道阻... 详细信息

目的确定肺气肿或外周气道的CT测量与慢性阻塞性肺疾病(COPD)气道阻塞之间的相关性。方法检索1976—2011年PubMed、Embase和Web of Knowledge数据库。两名独立研究者通过筛选1763篇有关应用CT测量慢性阻塞性肺病病人肺功能测试的气道阻塞参数的引用文章来评价研究的质量并总结相关的信息。研究者应用3种CT测量方法及2个气道阻塞参数进行评价,3种CT测量方法为:肺衰减面积百分比<-950HU(CT单位),平均肺密度及气道壁面积百分比;2个气道阻塞参数为:第1秒用力呼气量占预计值百分比(FEV1%预计值)和FEV1除以最大用力肺容量。结果系统回顾中有79篇(9559人)文章在不同的测量方法、测量数值及CT气道阻塞之间表现出相关性。选取15篇高质量文章(2095人)进行Meta分析。绝对汇集相关系数:吸气相CT为0.48(95%CI:0.40～0.54)～0.65(0.58～0.71),呼气相CT为0.64(0.53～0.72)～0.73(0.63～0.80)。结论肺气肿或外周气道的CT测量与慢性阻塞性肺病病人的气道阻塞显著相关。在研究慢性阻塞性肺疾病的气道阻塞时CT提供了形态学方法。

关键词：系统回顾 Meta分析 CT 慢性阻塞性肺疾病肺功能测试

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肝脏扩散加权成像的微量灌注效应

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国际医学放射学杂志 2012年第3期 304-304页

作者： H.Dijkstra P.Baron P.Kappert M.oudkerk P.E.Sijens 乔辉 Center for Medical Imaging-North East Netherlands Department of RadiologyUniversity of GroningenUniversity Medical Center GroningenEB44PO Box 300019700 RB GroningenThe Netherlands

目的临床的肝脏扩散加权成像(DWI)通常依赖单指数扩散。目的是证明肝脏的单指数扩散易与微量灌注混淆,因而需要双指数模型。方法19名禁食的健康志愿者行1.5T脂肪抑制及呼吸门控的DWI(7个b值)检查。在肝脏的

关键词：扩散加权成像体素内不一致运动成像(IVIM) 肝实质微量灌注 ADC差异性引入

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