1
|
van Gerwen M, Ma T, Yip R, Choi C, Paksashvili N, Yankelevitz D, Henschke C. Thyroid abnormalities identified on CT screening for lung cancer. Clin Imaging 2024; 110:110162. [PMID: 38691910 DOI: 10.1016/j.clinimag.2024.110162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 04/11/2024] [Accepted: 04/14/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Because incidental thyroid nodules (ITNs) are common extrapulmonary findings in low-dose computed tomography (LDCT) scans for lung cancer screening, we aimed to investigate the frequency of ITNs on LDCT scans separately on baseline and annual repeat scans, the frequency of malignancy among the ITNs, and any association with demographic, clinical, CT characteristics. METHODS Retrospective case series of all 2309 participants having baseline and annual repeat screening in an Early Lung and Cardiac Action Program (MS-ELCAP) LDCT lung screening program from January 2010 to December 2016 was performed. Frequency of ITNs in baseline and annual repeat rounds were determined. Multivariable regression analysis was performed to identify significant predictors. RESULTS Dominant ITNs were seen in 2.5 % of 2309 participants on baseline and in 0.15 % of participants among 4792 annual repeat LDCTs. The low incidence of new ITNs suggests slow growth as it would take approximately an average of 16.8 years for a new ITN to be detected on annual rounds of screening. Newly detected ITNs on annual repeat LDCT were all smaller than 15 mm. Regression analysis showed that the increasing of age, coronary artery calcifications score and breast density grade were significant predictors for females having an ITN. No significant predictors were found for ITNs in males. CONCLUSION ITNs are detected at LDCT however, no malignancy was found. Certain predictors for ITNs in females have been identified including breast density, which may point towards a common causal pathway.
Collapse
Affiliation(s)
- Maaike van Gerwen
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Teng Ma
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York 10029, USA; Department of Diagnostic Ultrasound, Tong Ren Hospital, Capital Medical University, Beijing 100730, China
| | - Rowena Yip
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York 10029, USA
| | - Chris Choi
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Natela Paksashvili
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York 10029, USA
| | - David Yankelevitz
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York 10029, USA
| | - Claudia Henschke
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York 10029, USA
| |
Collapse
|
2
|
Naghavi M, Yankelevitz D, Reeves AP, Budoff MJ, Li D, Atlas K, Zhang C, Atlas TL, Lirette S, Wasserthal J, Roy SK, Henschke C, Wong ND, Defilippi C, Heckbert SR, Greenland P. AI-enabled left atrial volumetry in coronary artery calcium scans (AI-CAC TM) predicts atrial fibrillation as early as one year, improves CHARGE-AF, and outperforms NT-proBNP: The multi-ethnic study of atherosclerosis. J Cardiovasc Comput Tomogr 2024:S1934-5925(24)00079-0. [PMID: 38653606 DOI: 10.1016/j.jcct.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/04/2024] [Accepted: 04/13/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Coronary artery calcium (CAC) scans contain actionable information beyond CAC scores that is not currently reported. METHODS We have applied artificial intelligence-enabled automated cardiac chambers volumetry to CAC scans (AI-CACTM) to 5535 asymptomatic individuals (52.2% women, ages 45-84) that were previously obtained for CAC scoring in the baseline examination (2000-2002) of the Multi-Ethnic Study of Atherosclerosis (MESA). AI-CAC took on average 21 s per CAC scan. We used the 5-year outcomes data for incident atrial fibrillation (AF) and assessed discrimination using the time-dependent area under the curve (AUC) of AI-CAC LA volume with known predictors of AF, the CHARGE-AF Risk Score and NT-proBNP. The mean follow-up time to an AF event was 2.9 ± 1.4 years. RESULTS At 1,2,3,4, and 5 years follow-up 36, 77, 123, 182, and 236 cases of AF were identified, respectively. The AUC for AI-CAC LA volume was significantly higher than CHARGE-AF for Years 1, 2, and 3 (0.83 vs. 0.74, 0.84 vs. 0.80, and 0.81 vs. 0.78, respectively, all p < 0.05), but similar for Years 4 and 5, and significantly higher than NT-proBNP at Years 1-5 (all p < 0.01), but not for combined CHARGE-AF and NT-proBNP at any year. AI-CAC LA significantly improved the continuous Net Reclassification Index for prediction of AF over years 1-5 when added to CHARGE-AF Risk Score (0.60, 0.28, 0.32, 0.19, 0.24), and NT-proBNP (0.68, 0.44, 0.42, 0.30, 0.37) (all p < 0.01). CONCLUSION AI-CAC LA volume enabled prediction of AF as early as one year and significantly improved on risk classification of CHARGE-AF Risk Score and NT-proBNP.
Collapse
Affiliation(s)
| | | | - Anthony P Reeves
- Department of Computer Engineering, Cornell University, Ithaca, NY, USA
| | | | - Dong Li
- The Lundquist Institute, Torrance, CA, USA
| | | | | | | | | | | | - Sion K Roy
- The Lundquist Institute, Torrance, CA, USA
| | | | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, CA, USA
| | | | | | | |
Collapse
|
3
|
Christensen J, Prosper AE, Wu CC, Chung J, Lee E, Elicker B, Hunsaker AR, Petranovic M, Sandler KL, Stiles B, Mazzone P, Yankelevitz D, Aberle D, Chiles C, Kazerooni E. ACR Lung-RADS v2022: Assessment Categories and Management Recommendations. J Am Coll Radiol 2024; 21:473-488. [PMID: 37820837 DOI: 10.1016/j.jacr.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/08/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
The ACR created the Lung CT Screening Reporting and Data System (Lung-RADS) in 2014 to standardize the reporting and management of screen-detected pulmonary nodules. Lung-RADS was updated to version 1.1 in 2019 and revised size thresholds for nonsolid nodules, added classification criteria for perifissural nodules, and allowed for short-interval follow-up of rapidly enlarging nodules that may be infectious in etiology. Lung-RADS v2022, released in November 2022, provides several updates including guidance on the classification and management of atypical pulmonary cysts, juxtapleural nodules, airway-centered nodules, and potentially infectious findings. This new release also provides clarification for determining nodule growth and introduces stepped management for nodules that are stable or decreasing in size. This article summarizes the current evidence and expert consensus supporting Lung-RADS v2022.
Collapse
Affiliation(s)
- Jared Christensen
- Vice Chair and Professor of Radiology, Department of Radiology, Duke University, Durham, North Carolina; Chair, ACR Lung-RADS Committee.
| | - Ashley Elizabeth Prosper
- Assistant Professor and Section Chief of Cardiothoracic Imaging, Department of Radiological Sciences, University of California, Los Angeles, California
| | - Carol C Wu
- Professor of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jonathan Chung
- Professor of Radiology Vice Chair of Quality Section Chief of Cardiopulmonary Imaging, University of Chicago, Chicago, Illinois
| | - Elizabeth Lee
- Clinical Associate Professor, Radiology, Michigan Medicine, Ann Arbor, Michigan
| | - Brett Elicker
- Chief of the Cardiac & Pulmonary Imaging Section, University of California, San Francisco, California
| | - Andetta R Hunsaker
- Brigham and Women's Hospital, Boston, Massachusetts; Associate Professor Harvard Medical School Chief Division of Thoracic Imaging
| | - Milena Petranovic
- Instructor, Radiology, Harvard Medical School Divisional Quality Director, Thoracic Imaging and Intervention, Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Kim L Sandler
- Associate Professor, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brendon Stiles
- Professor and Chair, Thoracic Surgery and Surgical Oncology, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York
| | | | | | - Denise Aberle
- Professor of Radiology, Department of Radiological Sciences; David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Caroline Chiles
- Professor of Radiology Director, Lung Screening Program, Atrium Health Wake Forest, Winston-Salem, North Carolina
| | - Ella Kazerooni
- Professor of Radiology & Internal Medicine and Associate Chief Clinical Officer for Diagnostics, Michigan Medicine/University of Michigan Medical School, Ann Arbor, Michigan; Clinical Information Management, University of Michigan Medical Group
| |
Collapse
|
4
|
Christensen J, Prosper AE, Wu CC, Chung J, Lee E, Elicker B, Hunsaker AR, Petranovic M, Sandler KL, Stiles B, Mazzone P, Yankelevitz D, Aberle D, Chiles C, Kazerooni E. ACR Lung-RADS v2022: Assessment Categories and Management Recommendations. Chest 2024; 165:738-753. [PMID: 38300206 DOI: 10.1016/j.chest.2023.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
The American College of Radiology created the Lung CT Screening Reporting and Data System (Lung-RADS) in 2014 to standardize the reporting and management of screen-detected pulmonary nodules. Lung-RADS was updated to version 1.1 in 2019 and revised size thresholds for nonsolid nodules, added classification criteria for perifissural nodules, and allowed for short-interval follow-up of rapidly enlarging nodules that may be infectious in etiology. Lung-RADS v2022, released in November 2022, provides several updates including guidance on the classification and management of atypical pulmonary cysts, juxtapleural nodules, airway-centered nodules, and potentially infectious findings. This new release also provides clarification for determining nodule growth and introduces stepped management for nodules that are stable or decreasing in size. This article summarizes the current evidence and expert consensus supporting Lung-RADS v2022.
Collapse
Affiliation(s)
- Jared Christensen
- Vice Chair and Professor of Radiology, Department of Radiology, Duke University, Durham, North Carolina; Chair, ACR Lung-RADS Committee.
| | - Ashley Elizabeth Prosper
- Assistant Professor and Section Chief of Cardiothoracic Imaging, Department of Radiological Sciences, University of California, Los Angeles, California
| | - Carol C Wu
- Professor of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jonathan Chung
- Professor of Radiology Vice Chair of Quality Section Chief of Cardiopulmonary Imaging, University of Chicago, Chicago, Illinois
| | - Elizabeth Lee
- Clinical Associate Professor, Radiology, Michigan Medicine, Ann Arbor, Michigan
| | - Brett Elicker
- Chief of the Cardiac & Pulmonary Imaging Section, University of California, San Francisco, California
| | - Andetta R Hunsaker
- Brigham and Women's Hospital, Boston, Massachusetts; Associate Professor Harvard Medical School Chief Division of Thoracic Imaging
| | - Milena Petranovic
- Instructor, Radiology, Harvard Medical School Divisional Quality Director, Thoracic Imaging and Intervention, Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Kim L Sandler
- Associate Professor, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brendon Stiles
- Professor and Chair, Thoracic Surgery and Surgical Oncology, Montefiore Health System, Albert Einstein College of Medicine, Bronx, New York
| | | | | | - Denise Aberle
- Professor of Radiology, Department of Radiological Sciences; David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Caroline Chiles
- Professor of Radiology Director, Lung Screening Program, Atrium Health Wake Forest, Winston-Salem, North Carolina
| | - Ella Kazerooni
- Professor of Radiology & Internal Medicine and Associate Chief Clinical Officer for Diagnostics, Michigan Medicine/University of Michigan Medical School, Ann Arbor, Michigan; Clinical Information Management, University of Michigan Medical Group
| |
Collapse
|
5
|
Naghavi M, Yankelevitz D, Reeves AP, Budoff MJ, Li D, Atlas KC, Zhang C, Atlas TL, Lirette S, Wasserthal J, Henschke C, Defilippi C, Heckbert SR, Greenland P. AI-enabled Left Atrial Volumetry in Cardiac CT Scans Improves CHARGE-AF and Outperforms NT-ProBNP for Prediction of Atrial Fibrillation in Asymptomatic Individuals: Multi-Ethnic Study of Atherosclerosis. medRxiv 2024:2024.01.22.24301384. [PMID: 38343816 PMCID: PMC10854349 DOI: 10.1101/2024.01.22.24301384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Background Coronary artery calcium (CAC) scans contain actionable information beyond CAC scores that is not currently reported. Methods We have applied artificial intelligence-enabled automated cardiac chambers volumetry to CAC scans (AI-CAC), taking on average 21 seconds per CAC scan, to 5535 asymptomatic individuals (52.2% women, ages 45-84) that were previously obtained for CAC scoring in the baseline examination (2000-2002) of the Multi-Ethnic Study of Atherosclerosis (MESA). We used the 5-year outcomes data for incident atrial fibrillation (AF) and compared the time-dependent AUC of AI-CAC LA volume with known predictors of AF, the CHARGE-AF Risk Score and NT-proBNP (BNP). The mean follow-up time to an AF event was 2.9±1.4 years. Results At 1,2,3,4, and 5 years follow-up 36, 77, 123, 182, and 236 cases of AF were identified, respectively. The AUC for AI-CAC LA volume was significantly higher than CHARGE-AF or BNP at year 1 (0.836, 0.742, 0.742), year 2 (0.842, 0.807,0.772), and year 3 (0.811, 0.785, 0.745) (p<0.02), but similar for year 4 (0.785, 0.769, 0.725) and year 5 (0.781, 0.767, 0.734) respectively (p>0.05). AI-CAC LA volume significantly improved the continuous Net Reclassification Index for prediction of AF over years 1-5 when added to CAC score (0.74, 0.49, 0.53, 0.39, 0.44), CHARGE-AF Risk Score (0.60, 0.28, 0.32, 0.19, 0.24), and BNP (0.68, 0.44, 0.42, 0.30, 0.37) respectively (p<0.01). Conclusion AI-CAC LA volume enabled prediction of AF as early as one year and significantly improved on risk classification of CHARGE-AF Risk Score and BNP.
Collapse
Affiliation(s)
| | | | | | | | - Dong Li
- The Lundquist Institute, 1124 W Carson St, Torrance, CA 90502
| | | | | | - Thomas L. Atlas
- Tustin Teleradiology, 13422 Newport Ave Suite I, Tustin, CA 92780
| | | | | | | | | | | | | |
Collapse
|
6
|
Avila RS, Krishnan K, Obuchowski N, Jirapatnakul A, Subramaniam R, Yankelevitz D. Calibration phantom-based prediction of CT lung nodule volume measurement performance. Quant Imaging Med Surg 2023; 13:6193-6204. [PMID: 37711774 PMCID: PMC10498266 DOI: 10.21037/qims-22-320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/22/2023] [Indexed: 09/16/2023]
Abstract
Background A calibration phantom-based method has been developed for predicting small lung nodule volume measurement bias and precision that is specific to a particular computed tomography (CT) scanner and acquisition protocol. Methods The approach involves CT scanning a simple reference object with a specific acquisition protocol, analyzing the scan to estimate the fundamental imaging properties of the CT acquisition system, generating numerous simulated images of a target geometry using the fundamental imaging properties, measuring the simulated images with a standard nodule volume segmentation algorithm, and calculating bias and precision performance statistics from the resulting volume measurements. We evaluated the ability of this approach to predict volume measurement bias and precision of Teflon spheres (diameters =4.76, 6.36, and 7.94 mm) placed within an anthropomorphic chest phantom when using 3M Scotch Magic™ tape as the reference object. CT scanning of the spheres was performed with 0.625, 1.25, and 2.5 mm slice thickness and spacing. Results The study demonstrated good agreement between predicted volumetric performance and observed volume measurement performance for both volumetric measurement bias and precision. The predicted and observed volume mean for all slice thicknesses was found to be 28% and 13% lower on average than the manufactured sphere volume, respectively. When restricted to 0.625 and 1.25 mm slice thickness scans, which are recommended for small lung nodule volume measurement, we found that the difference between predicted and observed volume coefficient of variation was less than 1.0 %. The approach also showed a resilience to varying CT image acquisition protocols, a critical capability when deploying in a real-world clinical setting. Conclusions This is the first report of a calibration phantom-based method's ability to predict both small lung nodule volume measurement bias and precision. Volume measurement bias and precision for small lung nodules can be predicted using simple low-cost reference objects to estimate fundamental CT image characteristics and modeling and simulation techniques. The approach demonstrates an improved method for predicting task specific, clinically relevant measurement performance using advanced and fully automated image analysis techniques and low-cost reference objects.
Collapse
Affiliation(s)
| | | | - Nancy Obuchowski
- Department of Quantitative Health Science, Cleveland Clinic, Cleveland, OH, USA
| | - Artit Jirapatnakul
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Hospital, New York, NY, USA
| | - Raja Subramaniam
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Hospital, New York, NY, USA
| | - David Yankelevitz
- Department of Diagnostic, Molecular and Interventional Radiology, Mount Sinai Hospital, New York, NY, USA
| |
Collapse
|
7
|
Naghavi M, De Oliveira I, Mao SS, Jaberzadeh A, Montoya J, Zhang C, Atlas K, Manubolu V, Montes M, Li D, Atlas T, Reeves A, Henschke C, Yankelevitz D, Budoff M. Opportunistic AI-enabled automated bone mineral density measurements in lung cancer screening and coronary calcium scoring CT scans are equivalent. Eur J Radiol Open 2023; 10:100492. [PMID: 37214544 PMCID: PMC10196960 DOI: 10.1016/j.ejro.2023.100492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Rationale and objectives We previously reported a novel manual method for measuring bone mineral density (BMD) in coronary artery calcium (CAC) scans and validated our method against Dual X-Ray Absorptiometry (DEXA). Furthermore, we have developed and validated an artificial intelligence (AI) based automated BMD (AutoBMD) measurement as an opportunistic add-on to CAC scans that recently received FDA approval. In this report, we present evidence of equivalency between AutoBMD measurements in cardiac vs lung CT scans. Materials and methods AI models were trained using 132 cases with 7649 (3 mm) slices for CAC, and 37 cases with 21918 (0.5 mm) slices for lung scans. To validate AutoBMD against manual measurements, we used 6776 cases of BMD measured manually on CAC scans in the Multi-Ethnic Study of Atherosclerosis (MESA). We then used 165 additional cases from Harbor UCLA Lundquist Institute to compare AutoBMD in patients who underwent both cardiac and lung scans on the same day. Results Mean±SD for age was 69 ± 9.4 years with 52.4% male. AutoBMD in lung and cardiac scans, and manual BMD in cardiac scans were 153.7 ± 43.9, 155.1 ± 44.4, and 163.6 ± 45.3 g/cm3, respectively (p = 0.09). Bland-Altman agreement analysis between AutoBMD lung and cardiac scans resulted in 1.37 g/cm3 mean differences. Pearson correlation coefficient between lung and cardiac AutoBMD was R2 = 0.95 (p < 0.0001). Conclusion Opportunistic BMD measurement using AutoBMD in CAC and lung cancer screening scans is promising and yields similar results. No extra radiation plus the high prevalence of asymptomatic osteoporosis makes AutoBMD an ideal screening tool for osteopenia and osteoporosis in CT scans done for other reasons.
Collapse
Affiliation(s)
- Morteza Naghavi
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Isabel De Oliveira
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Song Shou Mao
- Lundquist Institute, Harbor UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA
| | | | - Juan Montoya
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Chenyu Zhang
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Kyle Atlas
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Venkat Manubolu
- Lundquist Institute, Harbor UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA
| | - Marlon Montes
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | - Dong Li
- Emory University, 201 Dowman Dr, Atlanta, GA 30322, USA
| | - Thomas Atlas
- HeartLung AI Technologies, TMC Innovation, 2450 Holcomb Blvd, Houston, TX 77021
| | | | | | | | - Matthew Budoff
- Lundquist Institute, Harbor UCLA Medical Center, 1124 W Carson St, Torrance, CA 90502, USA
| |
Collapse
|
8
|
Ma N, Yip R, Lewis S, Dinani A, Wyatt C, Crane M, Jirapatnakul A, Li L, Aloman C, Bansal MB, Dieterich D, Wyatt B, Yankelevitz D, Henschke C, Branch AD. Environmental exposures are important risk factors for advanced liver fibrosis in African American adults. JHEP Rep 2023; 5:100696. [PMID: 36937989 PMCID: PMC10017423 DOI: 10.1016/j.jhepr.2023.100696] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/10/2023] [Accepted: 01/21/2023] [Indexed: 03/21/2023] Open
Abstract
Background & Aims The prevalence and aetiology of liver fibrosis vary over time and impact racial/ethnic groups unevenly. This study measured time trends and identified factors associated with advanced liver fibrosis in the United States. Methods Standardised methods were used to analyse data on 47,422 participants (≥20 years old) in the National Health and Nutrition Examination Survey (1999-2018). Advanced liver fibrosis was defined as Fibrosis-4 ≥2.67 and/or Forns index ≥6.9 and elevated alanine aminotransferase. Results The estimated number of people with advanced liver fibrosis increased from 1.3 million (95% CI 0.8-1.9) to 3.5 million (95% CI 2.8-4.2), a nearly threefold increase. Prevalence was higher in non-Hispanic Black and Mexican American persons than in non-Hispanic White persons. In multivariable logistic regression analysis, cadmium was an independent risk factor in all racial/ethnic groups. Smoking and current excessive alcohol use were risk factors in most. Importantly, compared with non-Hispanic White persons, non-Hispanic Black persons had a distinctive set of risk factors that included poverty (odds ratio [OR] 2.09; 95% CI 1.44-3.03) and susceptibility to lead exposure (OR 3.25; 95% CI 1.95-5.43) but did not include diabetes (OR 0.88; 95% CI 0.61-1.27; p =0.52). Non-Hispanic Black persons were more likely to have high exposure to lead, cadmium, polychlorinated biphenyls, and poverty than non-Hispanic White persons. Conclusions The number of people with advanced liver fibrosis has increased, creating a need to expand the liver care workforce. The risk factors for advanced fibrosis vary by race/ethnicity. These differences provide useful information for designing screening programmes. Poverty and toxic exposures were associated with the high prevalence of advanced liver fibrosis in non-Hispanic Black persons and need to be addressed. Impact and Implications Because liver disease often produces few warning signs, simple and inexpensive screening tests that can be performed by non-specialists are needed to allow timely diagnosis and linkage to care. This study shows that non-Hispanic Black persons have a distinctive set of risk factors that need to be taken into account when designing liver disease screening programs. Exposure to exogenous toxins may be especially important risk factors for advanced liver fibrosis in non-Hispanic Black persons.
Collapse
Key Words
- ALD, alcohol-associated liver disease
- ALT, alanine aminotransferase
- APC, annual percent change
- Aetiology
- BMI, body mass index
- CI, confidence interval
- Environmental toxins
- FIB-4, Fibrosis-4
- HBV, hepatitis B virus
- HCV, hepatitis C virus
- HR, hazard ratio
- KI, kidney insufficiency
- LF, liver fibrosis
- MA, Mexican American
- NAFLD, non-alcoholic fatty liver disease
- NEI, no exposure identified
- NHANES, National Health and Nutrition Evaluation Survey
- NHB, non-Hispanic Black
- NHW, non-Hispanic White
- Non-invasive scores
- O, other race
- PCB, polychlorinated biphenyl
- Q1–Q4, quartiles 1–4
- Racial disparities
- Screening
- ULN, upper limit of normal
- USFLI, US Fatty Liver Index
- VH, viral hepatitis
- WC, waist circumference
Collapse
Affiliation(s)
- Ning Ma
- Division of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Rowena Yip
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sara Lewis
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amreen Dinani
- Division of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Christina Wyatt
- Department of Medicine, Division of Nephrology, Duke University School of Medicine, Durham, NC, USA
| | - Michael Crane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Artit Jirapatnakul
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Li Li
- Division of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Costica Aloman
- Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Meena B. Bansal
- Division of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Douglas Dieterich
- Division of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Brooke Wyatt
- Division of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - David Yankelevitz
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claudia Henschke
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea D. Branch
- Division of Liver Diseases, Icahn School of Medicine Mount Sinai, New York, NY, USA
- Corresponding author. Address: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1123, New York, NY 10029, USA. Tel.: +1-212-659-8371; Fax: +1-212-849-2574.
| |
Collapse
|
9
|
Cavic M, Kerpel-Fronius A, Viola L, Ventura L, Jiang L, Sales dos Santos R, Yang D, Koegelenberg C, Zulueta J, Henschke C, Kazerooni E, Tammemägi M, Field J, Wynes M, Balata H, Yankelevitz D, Sozzi G, Lam S, Huber R. P1.02-02 Current Status, Challenges and Perspectives of Lung Cancer Screening in Low- and Middle-Income Countries. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
10
|
Avila R, Krishnan K, Wynes M, Connolly C, McWilliams A, Logan J, Henschke C, Yankelevitz D, Pastorino U, Santos R, Hochhegger B, Ashizawa K, Kobayashi T, Rzyman W, Jelitto-Gorska M, Field J, Mulshine J, Lam S. EP01.04-005 Quantitative Characteristics in Global CT Lung Cancer Screening Populations Using the ELIC Distributed Database and Computation Environment. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
11
|
Marron T, Maier B, LaMarche N, Hegde S, Belabed M, Mattiuz R, Hennequin C, LeBerichel J, Park M, Hall N, Ogrady D, Fitzgerald B, Gomez J, Doroshow D, Veluswamy R, Rolfo C, Smith C, Rohs N, Yankelevitz D, Chaddha U, Harkin T, Beasley M, Hirsch F, Merad M. P2.12-05 Cancer and Atopy: Parallel Drivers? IL-4 Blockade Synergizes with PD-L1 Blockade to Reverse Type-2Mediated Immunosuppression. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
12
|
Avila R, Krishnan K, Wynes M, Connolly C, McWilliams A, Logan J, Henschke C, Yankelevitz D, Pastorino U, Santos R, Hochhegger B, Ashizawa K, Kobayashi T, Rzyman W, Jelitto-Gorska M, Field J, Mulshine J, Lam S. MA11.07 The ELIC Distributed Database and Computation Environment for Analyses of Lung Cancer Screening LDCTs Across the World. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
Zhu Y, Cai Q, Yip R, Sun Q, Li P, Triphuridet N, Henschke C, Yankelevitz D. EP01.05-011 Radiologic Features of Nodules Attached to the Mediastinal or Diaphragmatic Pleura. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Marron TU, Galsky MD, Taouli B, Fiel MI, Ward S, Kim E, Yankelevitz D, Doroshow D, Guttman-Yassky E, Ungar B, Mehandru S, Golas BJ, Labow D, Sfakianos J, Nair SS, Chakravarty D, Buckstein M, Song X, Kenigsberg E, Gnjatic S, Brown BD, Sparano J, Tewari A, Schwartz M, Bhardwaj N, Merad M. Author Correction: Neoadjuvant clinical trials provide a window of opportunity for cancer drug discovery. Nat Med 2022; 28:1723. [DOI: 10.1038/s41591-022-01948-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
15
|
Fitzgerald BG, Marron TU, Sweeney R, Gomez J, Hall N, O'Grady D, Rolfo C, Veluswamy R, Doroshow D, Mandeli J, Yankelevitz D, Bhardwaj N, Gnjatic S, Hirsch FR, Merad M, Tsankov A, Flores R, Wolf A. Abstract CT205: A phase I/Ib trial of intratumoral Poly-ICLC in resectable malignant pleural mesothelioma. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-ct205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Malignant pleural mesothelioma (MPM) is usually fatal, though multimodality therapy— now including immunotherapy— has improved survival. Recurrence after surgery is close to 100%, even with adjuvant chemotherapy and radiation. Our collaborators have performed deep immunophenotyping of treatment-naïve MPM lesions using mass cytometry (CyTOF) and single-cell RNA sequencing (scRNAseq) to define the tumor microenvironment. A population of rare CD141+ dendritic cells (DC1) is disproportionately represented in some MPM lesions analyzed. These DC1 cells— which express high levels of Toll-like receptor 3 (TLR3)— are among the most potent cross-presenters of antigen and are key to priming anti-tumor CD4+ and CD8+ T cell responses. Polyinosinic-polycytidylic acid stabilized with polylysine and carboxymethylcellulose (poly-ICLC), is a double-stranded RNA host-targeted therapeutic viral-mimic. Poly-ICLC activates multiple innate immune receptors including TLR3 and melanoma differentiation-associated gene 5 (MDA5), leading to cross-presentation of antigen to T cells and induction of strong Th1 response. We hypothesize that injection of poly-ICLC prior to surgical resection may activate intratumoral (IT) DC1s, increase tumor antigen presentation to cytotoxic T cells, and induce tumor-specific immune surveillance.
Methods: This is a phase I/Ib study to evaluate the safety of IT poly-ICLC prior to surgical resection for patients with MPM (NCT04525859). The primary endpoint is safety as assessed by frequency and severity of toxicities by CTCAE 5.0. Secondary endpoints are objective response as measured by RECIST 1.1 and recurrence free survival measured from the time of first poly-ICLC injection. Exploratory endpoints include evaluation of circulating immune cells (including regulatory T cells and NK cells), evaluation of immune cell infiltration in pre-injection tumor biopsy and surgically resected tissue, as well as characterization of immune parameters such as local B cell specificity. The protocol features a Simon’s two-stage design, with six patients enrolled in a phase I safety cohort, proceeding to a phase Ib expansion cohort (additional 13 patients) if no more than 1 dose limiting toxicity occurs. Eligible patients must have MPM deemed operable by the treating thoracic surgeon. Eligible subjects may not have uncontrolled immunocompromised states or autoimmune disorders. After enrollment, patients undergo biopsies at which time 2mg poly-ICLC is injected across two sites in the tumor. Patients then undergo resection of the tumor (pleurectomy/decortication or extra pleural pneumonectomy per standard of care) at day 21+/- 7 after poly-ICLC injection. Blood is drawn at three points (prior to poly-ICLC injection, at time of surgery, and at a post-operative visit) for immune profiling. At the time of submission six patients have been treated and phase Ib accrual is continuing as planned. Interim analysis of phase I safety and exploratory endpoints will be reported in late 2022.
Citation Format: Bailey G. Fitzgerald, Thomas U. Marron, Robert Sweeney, Jorge Gomez, Nicole Hall, Daniel O'Grady, Christian Rolfo, Raj Veluswamy, Deborah Doroshow, John Mandeli, David Yankelevitz, Nina Bhardwaj, Sacha Gnjatic, Fred R. Hirsch, Miriam Merad, Alexander Tsankov, Raja Flores, Andrea Wolf. A phase I/Ib trial of intratumoral Poly-ICLC in resectable malignant pleural mesothelioma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT205.
Collapse
Affiliation(s)
- Bailey G. Fitzgerald
- 1Icahn School of Medicine at Mount Sinai, Division of Hematology and Medical Oncology, New York, NY
| | - Thomas U. Marron
- 1Icahn School of Medicine at Mount Sinai, Division of Hematology and Medical Oncology, New York, NY
| | - Robert Sweeney
- 2Icahn School of Medicine at Mount Sinai, Department of Immunology, New York, NY
| | - Jorge Gomez
- 1Icahn School of Medicine at Mount Sinai, Division of Hematology and Medical Oncology, New York, NY
| | - Nicole Hall
- 3Tisch Cancer Institute at Mount Sinai, New York, NY
| | | | - Christian Rolfo
- 1Icahn School of Medicine at Mount Sinai, Division of Hematology and Medical Oncology, New York, NY
| | - Raj Veluswamy
- 1Icahn School of Medicine at Mount Sinai, Division of Hematology and Medical Oncology, New York, NY
| | - Deborah Doroshow
- 1Icahn School of Medicine at Mount Sinai, Division of Hematology and Medical Oncology, New York, NY
| | - John Mandeli
- 4Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine & Public Health, New York, NY
| | - David Yankelevitz
- 5Icahn School of Medicine at Mount Sinai, Division of Diagnostic, Molecular and Interventional Radiology, New York, NY
| | - Nina Bhardwaj
- 2Icahn School of Medicine at Mount Sinai, Department of Immunology, New York, NY
| | - Sacha Gnjatic
- 2Icahn School of Medicine at Mount Sinai, Department of Immunology, New York, NY
| | - Fred R. Hirsch
- 1Icahn School of Medicine at Mount Sinai, Division of Hematology and Medical Oncology, New York, NY
| | - Miriam Merad
- 2Icahn School of Medicine at Mount Sinai, Department of Immunology, New York, NY
| | - Alexander Tsankov
- 6Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, New York, NY
| | - Raja Flores
- 7Icahn School of Medicine at Mount Sinai, Division of Thoracic Surgery, New York, NY
| | - Andrea Wolf
- 7Icahn School of Medicine at Mount Sinai, Division of Thoracic Surgery, New York, NY
| |
Collapse
|
16
|
Song KJ, Yip R, Chung M, Cai Q, Zhu Y, Singh A, Lewis EE, Yankelevitz D, Taioli E, Henschke C, Flores R. New or enlarging hiatal hernias after thoracic surgery for early lung cancer. JTCVS Open 2022; 10:415-423. [PMID: 36004265 PMCID: PMC9390567 DOI: 10.1016/j.xjon.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
Objective The study objective was to determine the relationship between lung resection and the development of postoperative hiatal hernia. Methods Preoperative and postoperative computed tomography imaging from 373 patients from the International Early Lung Cancer Action Program and the Initiative for Early Lung Cancer Research on Treatment were compared at a median of 31.1 months of follow-up after resection of clinical early-stage non–small cell lung cancer. Incidence of new hiatal hernia or changes to preexisting hernias were recorded and evaluated by patient demographics, surgical approach, extent of resection, and resection site. Results New hiatal hernias were seen in 9.6% of patients after lung resection (5.6% after wedge or segmentectomy and 12.4% after lobectomy; P = .047). The median size of new hernias was 21 mm, and the most commonly associated resection site was the left lower lobe (24.2%; P = .04). In patients with preexisting hernias, 53.5% demonstrated a small but significant increase in size from 21 to 22 mm (P < .0001). All hernias persisted through the latest postoperative computed tomography scan. When 110 surgical patients without preexisting hernia were matched by sex, age, and smoking to nonoperative controls, the incidence of new hernia at follow-up was significantly higher among those who underwent surgery (17.3% vs 2.7%, P = .0003). Conclusions Both open and minimally invasive lung resection for clinical early-stage lung cancer are associated with new or enlarging postoperative hiatal hernia, especially after resections involving the left lower lobe.
Collapse
Affiliation(s)
- Kimberly J. Song
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rowena Yip
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael Chung
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Qiang Cai
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Radiology, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China
| | - Yeqing Zhu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ayushi Singh
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Erik E. Lewis
- Department of Thoracic Surgery, University of Wisconsin Hospitals, Madison, Wis
| | - David Yankelevitz
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
- Tisch Center Institute, Icahn School of Medicine at Mount Sinai, New York, NY
- Center for Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Emanuela Taioli
- Tisch Center Institute, Icahn School of Medicine at Mount Sinai, New York, NY
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Claudia Henschke
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
- Tisch Center Institute, Icahn School of Medicine at Mount Sinai, New York, NY
- Center for Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
- Address for reprints: Claudia Henschke, MD, PhD, Department of Radiology, Icahn School of Medicine at Mount Sinai, Box 1234, One Gustave L. Levy Place, New York, NY 10029.
| | - Raja Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
- Tisch Center Institute, Icahn School of Medicine at Mount Sinai, New York, NY
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | |
Collapse
|
17
|
Marron TU, Galsky MD, Taouli B, Fiel MI, Ward S, Kim E, Yankelevitz D, Doroshow D, Guttman-Yassky E, Ungar B, Mehandru S, Golas BJ, Labow D, Sfakianos J, Nair SS, Chakravarty D, Buckstein M, Song X, Kenigsberg E, Gnjatic S, Brown BD, Sparano J, Tewari A, Schwartz M, Bhardwaj N, Merad M. Neoadjuvant clinical trials provide a window of opportunity for cancer drug discovery. Nat Med 2022; 28:626-629. [PMID: 35347282 PMCID: PMC9901535 DOI: 10.1038/s41591-022-01681-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Window-of-opportunity trials, during which patients receive short-duration pre-surgical therapies, provide a platform for understanding the therapies’ mechanisms of action, but will require a paradigm shift in trial design, specimen collection and analysis.
Collapse
Affiliation(s)
- Thomas U Marron
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Immunotherapy and Novel TargEt Research Across Clinical Teams (INTERACT), Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Early Phase Trials Unit, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Matthew D Galsky
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Early Phase Trials Unit, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bachir Taouli
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Isabel Fiel
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen Ward
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edward Kim
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Yankelevitz
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah Doroshow
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Early Phase Trials Unit, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emma Guttman-Yassky
- Immunotherapy and Novel TargEt Research Across Clinical Teams (INTERACT), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin Ungar
- Immunotherapy and Novel TargEt Research Across Clinical Teams (INTERACT), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Saurabh Mehandru
- Immunotherapy and Novel TargEt Research Across Clinical Teams (INTERACT), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin J Golas
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Labow
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Sfakianos
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sujit S Nair
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dimple Chakravarty
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Buckstein
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaoyu Song
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Effi Kenigsberg
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genomics and Genetics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sacha Gnjatic
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian D Brown
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genomics and Genetics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Sparano
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashutosh Tewari
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Myron Schwartz
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nina Bhardwaj
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Immunotherapy and Novel TargEt Research Across Clinical Teams (INTERACT), Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Early Phase Trials Unit, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Miriam Merad
- The neoAdjuvant Research Group to Evaluate Therapeutics (TARGET), Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Immunotherapy and Novel TargEt Research Across Clinical Teams (INTERACT), Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Early Phase Trials Unit, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Center of Excellence for Liver and Bile Duct Cancer, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Liver Cancer Program, Division of Liver Diseases and RM Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
18
|
Rolfo C, Meshulami N, Russo A, Krammer F, García-Sastre A, Mack PC, Gomez JE, Bhardwaj N, Benyounes A, Sirera R, Moore A, Rohs N, Henschke CI, Yankelevitz D, King J, Shyr Y, Bunn PA, Minna JD, Hirsch FR. Lung Cancer and Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Identifying Important Knowledge Gaps for Investigation. J Thorac Oncol 2021; 17:214-227. [PMID: 34774792 PMCID: PMC8579698 DOI: 10.1016/j.jtho.2021.11.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 12/12/2022]
Abstract
Patients with lung cancer are especially vulnerable to coronavirus disease 2019 (COVID-19) with a greater than sevenfold higher rate of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19, a greater than threefold higher hospitalization rate with high complication rates, and an estimated case fatality rate of more than 30%. The reasons for the increased vulnerability are not known. In addition, beyond the direct impact of the pandemic on morbidity and mortality among patients with lung cancer, COVID-19, with its disruption of patient care, has also resulted in substantial impact on lung cancer screening and treatment/management.COVID-19 vaccines are safe and effective in people with lung cancer. On the basis of the available data, patients with lung cancer should continue their course of cancer treatment and get vaccinated against the SARS-CoV-2 virus. For unknown reasons, some patients with lung cancer mount poor antibody responses to vaccination. Thus, boosting vaccination seems urgently indicated in this subgroup of vulnerable patients with lung cancer. Nevertheless, many unanswered questions regarding vaccination in this population remain, including the magnitude, quality, and duration of antibody response and the role of innate and acquired cellular immunities for clinical protection. Additional important knowledge gaps also remain, including the following: how can we best protect patients with lung cancer from developing COVID-19, including managing care in patient with lung cancer and the home environment of patients with lung cancer; are there clinical/treatment demographics and tumor molecular demographics that affect severity of COVID-19 disease in patients with lung cancer; does anticancer treatment affect antibody production and protection; does SARS-CoV-2 infection affect the development/progression of lung cancer; and are special measures and vaccine strategies needed for patients with lung cancer as viral variants of concern emerge.
Collapse
Affiliation(s)
- Christian Rolfo
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | - Noy Meshulami
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | - Alessandro Russo
- Medical Oncology Unit, Azienda Ospedaliera Papardo (A.O. Papardo), Messina, Italy
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Philip C Mack
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | - Jorge E Gomez
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nina Bhardwaj
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amin Benyounes
- Thoracic Oncology, Inova Schar Cancer Institute, Fairfax, Virginia
| | - Rafael Sirera
- Unidad Mixta TRIAL, Centro Investigación Príncipe Felipe-Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red Cáncer, CIBERONC, Madrid, Spain; Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
| | - Amy Moore
- LUNGevity Foundation, Bethesda, Maryland
| | - Nicholas Rohs
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York
| | | | - David Yankelevitz
- Department of Radiology, Mount Sinai Health System, New York, New York
| | - Jennifer King
- GO(2) Foundation for Lung Cancer, Washington, District of Columbia
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Paul A Bunn
- Division of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado
| | - John D Minna
- Division of Hematology and Oncology, Department of Internal Medicine, The Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, Texas; Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Fred R Hirsch
- Center of Excellence for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, at Mount Sinai, New York, New York.
| |
Collapse
|
19
|
Zhu Y, Cai Q, Wang Y, You N, Yip R, Henschke C, Yankelevitz D. P62.07 Pre-surgical Assessment of Mediastinal Lymph Node Metastases in Stage IA Non-small-cell Lung Cancers. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Yip R, Henschke C, Yankelevitz D. MA10.03 Balance Between Decreased False Positives and Delayed Diagnosis in Lung Cancer Screening. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
21
|
Sands J, Tammemägi MC, Couraud S, Baldwin DR, Borondy-Kitts A, Yankelevitz D, Lewis J, Grannis F, Kauczor HU, von Stackelberg O, Sequist L, Pastorino U, McKee B. Lung Screening Benefits and Challenges: A Review of The Data and Outline for Implementation. J Thorac Oncol 2021; 16:37-53. [PMID: 33188913 DOI: 10.1016/j.jtho.2020.10.127] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide, accounting for almost a fifth of all cancer-related deaths. Annual computed tomographic lung cancer screening (CTLS) detects lung cancer at earlier stages and reduces lung cancer-related mortality among high-risk individuals. Many medical organizations, including the U.S. Preventive Services Task Force, recommend annual CTLS in high-risk populations. However, fewer than 5% of individuals worldwide at high risk for lung cancer have undergone screening. In large part, this is owing to delayed implementation of CTLS in many countries throughout the world. Factors contributing to low uptake in countries with longstanding CTLS endorsement, such as the United States, include lack of patient and clinician awareness of current recommendations in favor of CTLS and clinician concerns about CTLS-related radiation exposure, false-positive results, overdiagnosis, and cost. This review of the literature serves to address these concerns by evaluating the potential risks and benefits of CTLS. Review of key components of a lung screening program, along with an updated shared decision aid, provides guidance for program development and optimization. Review of studies evaluating the population considered "high-risk" is included as this may affect future guidelines within the United States and other countries considering lung screening implementation.
Collapse
Affiliation(s)
- Jacob Sands
- Department of Medical Oncology, Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
| | - Martin C Tammemägi
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Sebastien Couraud
- Acute Respiratory Disease and Thoracic Oncology Department, Lyon Sud Hospital, Hospices Civils de Lyon Cancer Institute; EMR-3738 Therapeutic Targeting in Oncology, Lyon Sud Medical Faculty, Lyon 1 University, Lyon, France
| | - David R Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Andrea Borondy-Kitts
- Lung Cancer and Patient Advocate, Consultant Patient Outreach & Research Specialist, Lahey Hospital & Medical Center, Burlington, Massachusetts
| | - David Yankelevitz
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jennifer Lewis
- VA Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Fred Grannis
- City of Hope National Medical Center, Duarte, California
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology and Translational Lung Research Center, Member of the German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Oyunbileg von Stackelberg
- Department of Diagnostic and Interventional Radiology and Translational Lung Research Center, Member of the German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Lecia Sequist
- Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts
| | - Ugo Pastorino
- Thoracic Surgery Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Brady McKee
- Division of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts
| |
Collapse
|
22
|
Salvatore M, Toussie D, Pavlishyn N, Yankelevitz D, O'Connor T, Henschke C, Padilla M. The right upper lobe bronchus angle: A tool for differentiating fibrotic and non-fibrotic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2020; 37:99-103. [PMID: 33093775 PMCID: PMC7569551 DOI: 10.36141/svdld.v37i2.8965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/26/2020] [Indexed: 12/19/2022]
Abstract
Purpose: To evaluate the Right Upper Lobe Bronchus Angle (RUL-BA) on chest CT in patients with Stage 4 sarcoidosis and compare to others with non-fibrotic sarcoidosis. Methods: IRB approval was obtained for review of all chest CT scans performed from January 2015 through December 2017 that contained the word sarcoidosis using the computer program Montage. The most recent CT scans of 633 people were reviewed. The patients’ age and sex at the time of their most recent CT scan were recorded. The radiographic diagnosis and the Right Upper Lobe Bronchus Angle (RUL-BA) were determined by a chest radiologist with 20 years of experience. Results: The RUL-BA increased with Stage 4 sarcoidosis, measuring on average 104 degrees, compared to the average angle of 88 degrees for those without fibrotic sarcoid. More often men’s CT scans exhibited the earlier stages of sarcoidosis, and a higher number of women’s scans showed fibrotic sarcoidosis. As would be expected, scans with advanced disease were typically from older patients; however, there was no correlation between age and degree of fibrosis as measured by increasing RUL-BA. Conclusion: The RUL-BA assists radiologists in differentiating fibrotic sarcoidosis from non-fibrotic sarcoidosis. Further research will determine if the RUL-BA measurement can help differentiate fibrotic sarcoid from other fibrotic lung diseases and if the angle can be used to follow disease progression. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 99-103)
Collapse
Affiliation(s)
- Mary Salvatore
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Radiology, Columbia University Medical Center, New York, NY
| | - Danielle Toussie
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nadiya Pavlishyn
- Department of Radiology, Columbia University Medical Center, New York, NY
| | - David Yankelevitz
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Timothy O'Connor
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Claudia Henschke
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Maria Padilla
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
23
|
Bertolini A, Capaccione K, Austin JH, Blum A, Padilla M, DSouza B, Yankelevitz D, Henschke CI, Salvatore MM. Teleradiology: An opportunity to improve outcomes in pulmonary fibrosis. Clin Imaging 2020; 60:263-264. [DOI: 10.1016/j.clinimag.2019.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 05/14/2019] [Accepted: 05/22/2019] [Indexed: 11/28/2022]
|
24
|
Schneider BJ, Ismaila N, Aerts J, Chiles C, Daly ME, Detterbeck FC, Hearn JWD, Katz SI, Leighl NB, Levy B, Meyers B, Murgu S, Nekhlyudov L, Santos ES, Singh N, Tashbar J, Yankelevitz D, Altorki N. Lung Cancer Surveillance After Definitive Curative-Intent Therapy: ASCO Guideline. J Clin Oncol 2019; 38:753-766. [PMID: 31829901 DOI: 10.1200/jco.19.02748] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To provide evidence-based recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive curative-intent therapy in patients with stage I-III non-small-cell lung cancer (NSCLC) and SCLC. METHODS ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, radiology, primary care, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2019. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 14 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Patients should undergo surveillance imaging for recurrence every 6 months for 2 years and then annually for detection of new primary lung cancers. Chest computed tomography imaging is the optimal imaging modality for surveillance. Fluorodeoxyglucose positron emission tomography/computed tomography imaging should not be used as a surveillance tool. Surveillance imaging may not be offered to patients who are clinically unsuitable for or unwilling to accept further treatment. Age should not preclude surveillance imaging. Circulating biomarkers should not be used as a surveillance strategy for detection of recurrence. Brain magnetic resonance imaging should not be used for routine surveillance in stage I-III NSCLC but may be used every 3 months for the first year and every 6 months for the second year in patients with stage I-III small-cell lung cancer who have undergone curative-intent treatment.
Collapse
Affiliation(s)
| | | | - Joachim Aerts
- Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands
| | | | - Megan E Daly
- University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | | | | | - Sharyn I Katz
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Natasha B Leighl
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Benjamin Levy
- Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital, Washington, DC
| | | | | | | | | | - Navneet Singh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | |
Collapse
|
25
|
Marron T, Wolf A, Flores R, Veluswamy R, Gomez J, Beasley M, Yankelevitz D, Leader A, Lowy I, Miller E, Thurston G, Jankovic V, Deering R, Brown B, Rahman A, Gnjatic S, Hirsch F, Bhardwaj N, Merad M. EP1.04-15 NSCLC Response Determinants to Chemoimmunotherapy: Deep Profiling of Tumors Following Neoadjuvant Cemiplimab and Chemotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
26
|
Spalluto L, Lewis J, Callaway-Lane C, Stolldorf D, Prusaczyk B, Limper H, Audet C, Vogus T, Wiener R, Slatore C, Yankelevitz D, Henschke C, Dittus R, Massion P, Lindsell C, Kripalani S, Moghanaki D, Roumie C. P2.11-33 Organizational Readiness for Implementation of Lung Cancer Screening in a Veterans Affairs Healthcare System. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
27
|
|
28
|
Zhu Y, Wang Y, Gioia W, Yip R, Jirapatnakul A, Chung M, Yankelevitz D, Henschke C. MS10.03 Aortic Valve Calcifications. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
29
|
Henschke C, Reeves A, Avila R, Moghanaki D, Jirapatnakul A, Yankelevitz D. OA06.03 An Open Source Lung Screening Management System. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
30
|
|
31
|
Henschke C, Yip R, Ma T, Aguayo S, Zulueta J, Yankelevitz D. ES08.04 Management Algorithms. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
32
|
Wang Y, Yip R, Zhu Y, Fevrier E, Ma T, Van Gerwen M, Yankelevitz D, Flores R, Henschke C. P1.13-01 The Importance of Staging of Lung Cancers, 30 mm or Less, Separately for Subsolid and Solid Nodules. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
|
34
|
Yankelevitz D. ES08.03 The Magnitude of the Benefit. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
35
|
Yankelevitz D. S01.11 Framing Current Status. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
36
|
Whittaker Brown SA, Padilla M, Mhango G, Powell C, Salvatore M, Henschke C, Yankelevitz D, Sigel K, de-Torres JP, Wisnivesky J. Interstitial Lung Abnormalities and Lung Cancer Risk in the National Lung Screening Trial. Chest 2019; 156:1195-1203. [PMID: 31404527 DOI: 10.1016/j.chest.2019.06.041] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/11/2019] [Accepted: 06/25/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Some interstitial lung diseases are associated with lung cancer. However, it is unclear whether asymptomatic interstitial lung abnormalities convey an independent risk. OBJECTIVES The goal of this study was to assess whether interstitial lung abnormalities are associated with an increased risk of lung cancer. METHODS Data from all participants in the National Lung Cancer Trial were analyzed, except for subjects with preexisting interstitial lung disease or prevalent lung cancers. The primary analysis included those who underwent low-dose CT imaging; those undergoing chest radiography were included in a confirmatory analysis. Participants with evidence of reticular/reticulonodular opacities, honeycombing, fibrosis, or scarring were classified as having interstitial lung abnormalities. Lung cancer incidence and mortality in participants with and without interstitial lung abnormalities were compared by using Poisson and Cox regression, respectively. RESULTS Of the 25,041 participants undergoing low-dose CT imaging included in the primary analysis, 20.2% had interstitial lung abnormalities. Participants with interstitial lung abnormalities had a higher incidence of lung cancer (incidence rate ratio, 1.61; 95% CI, 1.30-1.99). Interstitial lung abnormalities were associated with higher lung cancer incidence on adjusted analyses (incidence rate ratio, 1.33; 95% CI, 1.07-1.65). Lung cancer-specific mortality was also greater in participants with interstitial lung abnormalities. Similar findings were obtained in the analysis of participants undergoing chest radiography. CONCLUSIONS Asymptomatic interstitial lung abnormalities are an independent risk factor for lung cancer that can be incorporated into risk score models.
Collapse
Affiliation(s)
- Stacey-Ann Whittaker Brown
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Maria Padilla
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Grace Mhango
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Charles Powell
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mary Salvatore
- Division of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Claudia Henschke
- Division of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David Yankelevitz
- Division of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Keith Sigel
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Juan P de-Torres
- Division of Respiratory Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan Wisnivesky
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
37
|
Salvatore M, Singh A, Yip R, Fevrier E, Henschke CI, Yankelevitz D, Padilla M. Progression of probable UIP and UIP on HRCT. Clin Imaging 2019; 58:140-144. [PMID: 31326632 DOI: 10.1016/j.clinimag.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/14/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To determine patterns of progression of probable Usual Interstitial Pneumonitis (UIP). METHODS This HIPPA compliant, IRB-approved study draws patients from our Fibrosis Registry. All patients with a consensus diagnosis of Idiopathic Pulmonary Fibrosis (IPF) were included. Most recent CT scans and all earlier CT scans were reviewed to determine the fibrosis grade in each lobe based on probable UIP (pUIP) findings of ground glass opacities, traction bronchiolectasis and reticulations or UIP findings of subpleural basilar predominant fibrosis with honeycombing (HC) and absence of features that would suggest an alternative diagnosis. RESULTS 103 patients with a working diagnosis of IPF are the focus of this report. Among the 68 with pUIP on the initial CT, 32 (47%) progressed; median time to progression was 51 months. The risk of HC progression, adjusted for gender, of patients with emphysema was 2.53 times higher than patients without emphysema (HR = 2.53, 95% CI: 1.06-6.02). Among the 35 with HC on the initial CT scan, 20 (57%) progressed to more advanced HC; median time to progression was 31 months. Increased pulmonary artery size was significantly associated with an elevated risk for more advanced HC progression (HR = 1.16, 95% CI: 1.04-1.31). CONCLUSION Ground glass opacities, traction bronchiolectasis and reticulations, a "Probable UIP Pattern" by ATS criteria progressed to UIP in 47% of patients on follow-up imaging.
Collapse
Affiliation(s)
- Mary Salvatore
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Radiology, Columbia University Medical Center, New York, NY, United States of America.
| | - Ayushi Singh
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Rowena Yip
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Esther Fevrier
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Claudia I Henschke
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - David Yankelevitz
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Maria Padilla
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| |
Collapse
|
38
|
Yip R, Ma T, Flores RM, Yankelevitz D, Henschke CI. Survival with Parenchymal and Pleural Invasion of Non-Small Cell Lung Cancers Less than 30 mm. J Thorac Oncol 2019; 14:890-902. [PMID: 30685507 DOI: 10.1016/j.jtho.2019.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/12/2018] [Accepted: 01/06/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine long-term survival of visceral pleural invasion (VPI) and parenchymal invasion (PAI) (angiolymphatic and/or vascular) on survival of NSCLCs less than 30 mm in maximum diameter. METHODS Kaplan-Meier survivals for NSCLCs, with and without VPI and/or PAI, were determined for a prospective cohort of screening participants stratified by pathologic tumor size (≤10 mm, 11-20 mm, and 21-30 mm) and nodule consistency. Log-rank test statistics were calculated. RESULTS The frequency of PAI versus VPI was significantly lower in patients with subsolid nodules than in those with solid nodules (4.9% versus 27.7% [p < 0.0001]), and correspondingly, Kaplan-Meier lung cancer survival was significantly higher among patients with subsolid nodules (99.1% versus 91.3% [p = 0.0009]). Multivariable Cox regression found that only tumor diameter (adjusted hazard ratio [HR] =1.07, 95% confidence interval [CI]: 1.01-1.14, p = 0.02) and PAI (adjusted HR = 3.15, 95% CI: 1.25-7.90, p = 0.01) remained significant, whereas VPI was not significant (p = 0.15). When clinical and computed tomography findings were included with the pathologic findings, Cox regression showed that the risk of dying of lung cancer increased 10-fold (HR = 10.06, 95% CI: 1.35-75.30) for NSCLCs in patients with solid nodules and more than twofold (by a factor of 2.27) in patients with moderate to severe emphysema (HR = 2.27, 95% CI: 1.01-5.11), as well as with increasing tumor diameter (HR = 1.06, 95% CI: 1.01-1.13), whereas PAI was no longer significant (p = 0.19). CONCLUSIONS Nodule consistency on computed tomography was a more significant prognostic indicator than either PAI or VPI. We propose that patients with NSCLC with VPI and a maximum tumor diameter of 30 mm or less not be upstaged to T2 without further large, multicenter studies of NSCLCs, stratified by the new T status and that classification be considered separately for patients with subsolid or solid nodules.
Collapse
Affiliation(s)
- Rowena Yip
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Teng Ma
- Department of Diagnostic Ultrasound, Tong Ren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Raja M Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - David Yankelevitz
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Claudia I Henschke
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | | |
Collapse
|
39
|
Yankelevitz D. S01.04 Lung Cancer Screening: 1999 to Date – What Have We Learnt? J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
40
|
Yankelevitz D. ES01.02 Image Interpretation and Advances from the Perspective of the Radiologist. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
41
|
Flores R, Taioli E, Yankelevitz DF, Becker BJ, Jirapatnakul A, Reeves A, Schwartz R, Yip R, Fevrier E, Tam K, Steiger B, Henschke CI, Flores R, Kaufman A, Lee DS, Nicastri D, Wolf A, Rosenzweig K, Gomez J, Beasley MB, Zakowski M, Chung M, Yankelevitz D, Henschke C, Futamura R, Kantor S, Wallace C, Bhora F, Raad W, Evans A, Choi W, Buyuk Z, Friedman A, Dreifuss R, Verzosa S, Yakubox M, Aloferdova K, Stacey P, De Nobrega S, Futamura R, Kantor S, Wallace C, Hakami A, Tam K, Wallace C, Pass H, Crawford B, Donnington J, Cooper B, Moreirea A, Sorensen A, Kohman L, Dunton R, Wallen J, Curtiss C, Scalzetti E, Ellinwood L, Aye R, Vallieres E, Louie B, Frivar A, Mehta V, Manning K, Chona M, Smith A, Connery CP, Torres E, Cruzer D, Gendron B, Alyea S, Lackaye D, Studer L, Flores R, Henschke C, Taioli E, Yankelevitz D, Becker B, Jirapatnakul A, Reeves A, Schwartz R, Yip R, Fevrier E, Tam K, Steiger B. Initiative for Early Lung Cancer Research on Treatment: Development of Study Design and Pilot Implementation. J Thorac Oncol 2018; 13:946-957. [DOI: 10.1016/j.jtho.2018.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/31/2018] [Accepted: 03/04/2018] [Indexed: 01/15/2023]
|
42
|
Margolies LR, Salvatore M, Yip R, Tam K, Bertolini A, Henschke C, Yankelevitz D. The chest radiologist's role in invasive breast cancer detection. Clin Imaging 2018; 50:13-19. [DOI: 10.1016/j.clinimag.2017.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/25/2017] [Accepted: 12/05/2017] [Indexed: 11/12/2022]
|
43
|
Henschke C, Yip R, Chung M, Jirapatnakul A, Avila R, Yankelevitz D. PL 01.02 Major Advances in CT Screening: A Radiologist's Perspective. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
44
|
Flores R, Taioli E, Yankelevitz D, Yip R, Becker B, Jirapatnakul A, Reeves A, Schwartz R, Tam K, Henschke C. P2.16-022 Initiative for Early Lung Cancer Research on Treatment: Pilot Implementation. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
45
|
Avila R, Henschke C, Yankelevitz D. WS 02.15 Quality Control for Lung Imaging Biomarkers. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
46
|
Yip R, Li K, Henschke C, Yankelevitz D. P2.16-014 Deconstructing Surgical Decision Making. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
47
|
Tuminello S, Liu B, Lieberman-Cribbin W, Yankelevitz D, Henschke C, Flores R, Taioli E. P2.13-026 Determining the Effect of Screening on Lung Cancer Mortality. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
48
|
Jirapatnakul A, Reeves A, Yip R, Liu S, Xie Y, Flores R, Henschke C, Yankelevitz D. P2.16-024 Effect of Resection of Stage 1 Lung Cancer on Lung Volume. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
49
|
|
50
|
Yankelevitz D. MTE 14.02 Diagnostic Intervention for Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|