Ernst Th. Scholten

Bio: Ernst Th. Scholten is an academic researcher from Radboud University Nijmegen Medical Centre. The author has contributed to research in topics: Lung cancer screening & Lung cancer. The author has an hindex of 12, co-authored 16 publications receiving 1068 citations. Previous affiliations of Ernst Th. Scholten include Analysis Group & Erasmus University Rotterdam.

Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial

Abstract: Background There are limited data from randomized trials regarding whether volume-based, low-dose computed tomographic (CT) screening can reduce lung-cancer mortality among male former and...

Long-term effects of lung cancer computed tomography screening on health-related quality of life: the NELSON trial

Abstract: The long-term effects of lung cancer computed tomography (CT) screening on health-related quality of life (HRQoL) have not yet been investigated In the Dutch–Belgian Randomised Lung Cancer Screening Trial (NELSON trial), 1,466 participants received questionnaires before randomisation (T0), 2 months after baseline screening (screen group only; T1) and at 2-yr follow-up (T2) HRQoL was measured as generic HRQoL (12-item short-form questionnaire and EuroQoL questionnaire), anxiety (Spielberger State-Trait Anxiety Inventory) and lung cancer-specific distress (impact of event scale (IES)) Repeated measures of ANOVA were used to analyse differences between the screen and control groups, and between indeterminate (requiring a follow-up CT) and negative screening result groups At T0 and T2 there were no significant differences in HRQoL scores over time between the screen and control groups, or between the indeterminate or negative second-round screening result group There was a temporary increase in IES scores after an indeterminate baseline result (T0: mean 40 (95% CI 28–53); T1: mean 78 (95% CI 65–90); T2: mean 45 (95% CI 33–58)) At 2-yr follow-up, the HRQoL of screened subjects was similar to that of control subjects, the unfavourable short-term effects of an indeterminate baseline screening result had resolved and an indeterminate result at the second screening round had no impact on HRQoL

Effect of nodule characteristics on variability of semiautomated volume measurements in pulmonary nodules detected in a lung cancer screening program.

Abstract: Purpose: To retrospectively assess volume measurement variability in solid pulmonary nodules (volume, 15–500 mm3) detected at lung cancer screening and to quantify the independent effects of nodule morphology, size, and location. Materials and Methods: This retrospective study was a substudy of the screening program that was approved by the Dutch Ministry of Health, and all participants provided written informed consent. Two independent readers used semiautomated software to measure the volume of pulmonary nodules detected in 6774 participants aged 50–75 years (5917 men). Nodules were classified according to their location (purely intraparenchymal, pleural based, juxtavascular, or fissure attached), morphology (smooth, polylobulated, spiculated, or irregular), and size (≤50 mm3 or >50 mm3). The level of agreement was expressed by using the absolute values of the relative volume differences (RVDs). Multivariate logistic regression analysis was performed, and odds ratios (ORs) were computed to quantify the ...

Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening

Abstract: Objectives To analyse computed tomography (CT) findings of interval and post-screen carcinomas in lung cancer screening.

Detection and quantification of the solid component in pulmonary subsolid nodules by semiautomatic segmentation

Abstract: To determine whether semiautomatic volumetric software can differentiate part-solid from nonsolid pulmonary nodules and aid quantification of the solid component. As per reference standard, 115 nodules were differentiated into nonsolid and part-solid by two radiologists; disagreements were adjudicated by a third radiologist. The diameters of solid components were measured manually. Semiautomatic volumetric measurements were used to identify and quantify a possible solid component, using different Hounsfield unit (HU) thresholds. The measurements were compared with the reference standard and manual measurements. The reference standard detected a solid component in 86 nodules. Diagnosis of a solid component by semiautomatic software depended on the threshold chosen. A threshold of −300 HU resulted in the detection of a solid component in 75 nodules with good sensitivity (90 %) and specificity (88 %). At a threshold of −130 HU, semiautomatic measurements of the diameter of the solid component (mean 2.4 mm, SD 2.7 mm) were comparable to manual measurements at the mediastinal window setting (mean 2.3 mm, SD 2.5 mm [p = 0.63]). Semiautomatic segmentation of subsolid nodules could diagnose part-solid nodules and quantify the solid component similar to human observers. Performance depends on the attenuation segmentation thresholds. This method may prove useful in managing subsolid nodules. • Semiautomatic segmentation can accurately differentiate nonsolid from part-solid pulmonary nodules • Semiautomatic segmentation can quantify the solid component similar to manual measurements • Semiautomatic segmentation may aid management of subsolid nodules following Fleischner Society recommendations • Performance for the segmentation of subsolid nodules depends on the chosen attenuation thresholds

Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.

Abstract: This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

Clinical practice guidelines in oncology

Abstract: Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.

Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial

Abstract: Background There are limited data from randomized trials regarding whether volume-based, low-dose computed tomographic (CT) screening can reduce lung-cancer mortality among male former and...

Deep Learning Applications in Medical Image Analysis

Abstract: The tremendous success of machine learning algorithms at image recognition tasks in recent years intersects with a time of dramatically increased use of electronic medical records and diagnostic imaging. This review introduces the machine learning algorithms as applied to medical image analysis, focusing on convolutional neural networks, and emphasizing clinical aspects of the field. The advantage of machine learning in an era of medical big data is that significant hierarchal relationships within the data can be discovered algorithmically without laborious hand-crafting of features. We cover key research areas and applications of medical image classification, localization, detection, segmentation, and registration. We conclude by discussing research obstacles, emerging trends, and possible future directions.

American Cancer Society lung cancer screening guidelines

Abstract: Findings from the National Cancer Institute’s National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30–pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation. CA Cancer J Clin 2013;000:000-000. V C 2013 American Cancer Society.