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Lambert R, Baraliakos X, Bernard S, Carrino J, Diekhoff T, Eshed I, Hermann KG, Herregods N, Jaremko JL, Jans L, Jurik AG, O’neill J, Reijnierse M, Tuite M, Maksymowych WP. POS0989 DEVELOPMENT OF INTERNATIONAL CONSENSUS ON A STANDARDIZED IMAGE ACQUISITION PROTOCOL FOR DIAGNOSTIC EVALUATION OF THE SACROILIAC JOINTS BY MRI – AN ASAS-SPARTAN COLLABORATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIn 2009, ASAS published a ‘Definition of active sacroiliitis on MRI for classification of axial spondyloarthritis (axSpA)’. This definition relied on two MRI sequences to make this determination – semicoronal T1 and STIR. Since then, this approach has frequently been used for diagnosis, even though that was never the intent of the definition. In 2015, the European Society of Skeletal Radiology (ESSR) published its recommendations for an SIJ MRI image acquisition protocol (IAP) for diagnostic purposes that required 4 MRI sequences but there is still no IAP that has been widely accepted as a minimum standard worldwide. In 2020, an informal survey of 24 academic sites (12 Europe, 12 North America) confirmed that 24/24 sites performed a minimum of 3 MRI sequences for diagnosis (19 performed 4-8 sequences) because the 2-sequence protocol was considered inadequate.ObjectivesTo develop the minimum requirements for a standardized IAP for MRI of the sacroiliac joints for diagnostic ascertainment of sacroiliitis.MethodsAll radiologist members of the ASAS and SPARTAN Classification in axSpA (CLASSIC) project, along with one European and one North American rheumatologist with extensive MRI experience in SpA clinical practice and research, were invited to participate in a consensus exercise. A draft IAP was circulated to all participants along with background information and justification for the draft proposal. Feedback on all issues was received by email, tabulated and recirculated. Participants were broadly in favour of the proposal and two months later a teleconference meeting took place and remaining points of contention were resolved. Examples of the proposed IAP performed on new, 10 and 22 years’ old MRI scanners were made available for review in DICOM format. Next the revised draft of the IAP was presented at the ASAS annual meeting to the entire membership on 14 January 2022, and voted on.ResultsA 4-sequence IAP, 3-semicoronal and 1-semiaxial, is recommended for diagnostic ascertainment of sacroiliitis and its differential diagnoses (Table 1). It must meet the following requirements: Semicoronal sequences should be parallel to the dorsal cortex of the S2 vertebral body, and include: 1) a sequence sensitive for the detection of active inflammation being T2-weighted with suppression of fat signal; 2) a sequence sensitive for the detection of structural damage in bone and bone marrow with T1-weighting; 3) a sequence that is designed to optimally depict the bone-cartilage interface of the articular surface and be sensitive for detection of bone erosion; plus 4) a semiaxial sequence sensitive for inflammation detection. The IAP was approved at the ASAS annual meeting by a vote of the entire membership with 91% in favour.Table 1.A standardized SIJ MRI Acquisition Protocol for diagnostic ascertainment of sacroiliitisOrientationSequenceTarget Lesion(s)Semicoronal Parallel to the dorsal cortex of the S2 vertebral bodyT1-weighted Spin EchoStructural: Fat lesions, erosion, sclerosis, backfill, ankylosis.T2-weighted with suppressed fat signal (STIR, T2FS or equivalent)Inflammatory: Bone marrow edema (BME)T1-weighted with suppressed fat signal (2D or 3D T1FS)Structural: Erosion of the articular surfaceSemiaxial Perpendicular to semicoronalT2-weighted with suppressed fat signal (STIR, T2FS or equivalent)Inflammatory: Bone marrow edema (BME)ConclusionA standardized IAP for MRI of the sacroiliac joints for diagnostic ascertainment of sacroiliitis is recommended and should be comprised of a minimum of 4 sequences, in 2-planes, that will optimally visualize inflammation, structural damage, and the bone-cartilage interface.Disclosure of InterestsRobert Lambert Paid instructor for: Novartis, Consultant of: Calyx, CARE Arthritis, Image Analysis Group, Xenofon Baraliakos Speakers bureau: Abbvie, Pfizer, MSD, UCB, Novartis, Lilly, Galapagos, Hexal, Paid instructor for: Abbvie, Pfizer, MSD, UCB, Novartis, Lilly, Galapagos, Hexal, Consultant of: Abbvie, Pfizer, MSD, UCB, Novartis, Lilly, Galapagos, Hexal, Grant/research support from: Abbvie, MSD, Novartis, Lilly, Stephanie Bernard Consultant of: Elsevier Amirsys, John Carrino Consultant of: Pfizer, Regeneron, Globus, Carestream, Image Analysis Group, Image Biopsy Lab, Torsten Diekhoff Speakers bureau: Novartis, MSD, Canon MS, Consultant of: Eli Lilly, Iris Eshed: None declared, Kay-Geert Hermann Speakers bureau: AbbVie, Pfizer, MSD, Novartis. Co-founder: BerlinFlame GmbH, Nele Herregods: None declared, Jacob L Jaremko: None declared, Lennart Jans: None declared, Anne Grethe Jurik: None declared, John O’Neill: None declared, Monique Reijnierse: None declared, Michael Tuite Consultant of: GE HealthCare, Walter P Maksymowych Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, UCB, Consultant of: Abbvie, Boehringer Ingelheim, Celgene, Eli-Lilly, Galapagos, Novartis, Pfizer, UCB, Grant/research support from: Abbvie, Novartis, Pfizer, UCB
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Jaremko JL, Felfeliyan B, Rakkunedeth A, Thejeel B, Quinn-Laurin V, Østergaard M, Conaghan PG, Lambert R, Ronsky J, Maksymowych WP. AB0594 IMPROVING OSTEOARTHRITIS CARE BY AUTOMATIC MEASUREMENT OF HIP EFFUSION USING AI. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Osteoarthritis (OA) is the commonest disease affecting hip joints and has high prevalence across various age groups [1,2]. Effusion is a hallmark of OA and could represent a potential target for therapy [3–5]. Positive correlations of effusion to clinical outcomes are not well established, partly due to variability in manual assessment. Voxel-based volume quantification could reduce this variability [6].Objectives:We examine the inter-observer agreement of manual assessment of voxel-based effusion volume from coronal STIR MRI sequences at two time points and examine the feasibility of using Artificial Intelligence (AI) for standalone volume assessment.Methods:Our algorithm is based on Mask R-CNN [7] and was trained on labeled effusion regions in MRI slices from 68 patients with hip osteoarthritis. For validation, 2 human readers measured effusion from MRI STIR sequences of 25 patients at baseline and at 8 weeks follow-up. AI was used to measure effusion volume as an independent reader. Agreement between human readers and AI was assessed using absolute difference in volume (DV), Coefficients of Variation (CoV) and intraclass correlation coefficient (ICC).Results:Effusion regions detected by AI closely correlated with manual segmentation (Figure 1) for all samples. Differences in volumes measured by each pair of readers are summarized in Table 1. Agreement was excellent between human readers (ICC=0.99) and for each reader vs AI (ICC = 0.85-0.87).Figure 1.Mask overlays of regions of joint fluid detected by human readers (green, column 2) and AI (red, column 3) from 3 different patients. Raw MRI images are shown in column 1.Table 1.Comparison of volumes measured in cubic millimeters and agreement between each pair of readers (with AI as the 3rd reader)Volumes measured by readersAgreement between reader pairsReaderOverall VolumeMean ± Standard DeviationReader PairDifference in VolumeMean ± Standard DeviationCoVICCReader 16943 ± 5845Reader 1-21127 ± 9000.210.99 [0.98, 1.0]Reader 27638 ± 5619Reader 1-AI3311 ±16430.350.87 [0.7, 0.94]AI11014 ± 4454Reader 2-AI4151 ± 49860.270.85 [0.66,0.94]Conclusion:Initial results of automatic effusion measurement using AI show high agreement with human experts. This has potential to reduce variability and save expert time in OA MRI assessment, and to lead to improved OA care.References:[1]Sharif B, Garner R, Hennessy D, Sanmartin C, Flanagan WM, Marshall DA. Productivity costs of work loss associated with osteoarthritis in Canada from 2010 to 2031. Osteoarthritis Cartilage. 2017 Feb;25(2):249–58.[2]Sharif B, Kopec J, Bansback N, Rahman MM, Flanagan WM, Wong H, et al. Projecting the direct cost burden of osteoarthritis in Canada using a microsimulation model. Osteoarthritis Cartilage. 2015 Oct;23(10):1654–63.[3]Loeuille D, Chary-Valckenaere I, Champigneulle J, Rat A-C, Toussaint F, Pinzano-Watrin A, et al. Macroscopic and microscopic features of synovial membrane inflammation in the osteoarthritic knee: correlating magnetic resonance imaging findings with disease severity. Arthritis Rheum. 2005 Nov;52(11):3492–501.[4]Fernandez-Madrid F, Karvonen RL, Teitge RA, Miller PR, An T, Negendank WG. Synovial thickening detected by MR imaging in osteoarthritis of the knee confirmed by biopsy as synovitis. Magn Reson Imaging. 1995;13(2):177–83.[5]Atukorala I, Kwoh CK, Guermazi A, Roemer FW, Boudreau RM, Hannon MJ, et al. Synovitis in knee osteoarthritis: a precursor of disease? Ann Rheum Dis. 2016 Feb;75(2):390–5.[6]Quinn-Laurin V, Thejeel B, Chauvin NA, Brandon TG, Weiss PF, Jaremko JL. Normal hip joint fluid volumes in healthy children of different ages, based on MRI volumetric quantitative measurement. Pediatr Radiol. 2020 Oct;50(11):1587–93.[7]He K, Gkioxari G, Dollár P, Girshick R. Mask r-cnn. In: Proceedings of the IEEE international conference on computer vision. openaccess.thecvf.com; 2017. p. 2961–9.Acknowledgements:Jacob Jaremko is supported by the AHS Chair in Diagnostic Imaging at the University of Alberta. Medical Imaging Consultants (MIC) funds musculoskeletal radiology fellowships for Vanessa Quinn-Laurin at the University of Alberta, and provides Jacob Jaremko and Robert Lambert with protected academic time. Banafshe Felfeliyan is supported by an Alberta Innovates Graduate Student Scholarship for Data-Enabled Innovation.Disclosure of Interests:None declared.
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Mineli T, Sawakuchi A, Guralnik B, Lambert R, Jain M, Pupim F, Rio I, Guedes C, Nogueira L. Variation of luminescence sensitivity, characteristic dose and trap parameters of quartz from rocks and sediments. RADIAT MEAS 2021. [DOI: 10.1016/j.radmeas.2021.106583] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Spergel J, Fleischer D, Kim E, Campbell D, Green T, Bee K, Lambert R, Ocheltree T, Sampson H. P300 EVALUATION OF DAILY PATCH APPLICATION DURATION FOR EPICUTANEOUS IMMUNOTHERAPY FOR PEANUT ALLERGY. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.136] [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: 10/23/2022]
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Yukihara E, Coleman A, Biswas R, Lambert R, Herman F, King G. Thermoluminescence analysis for particle temperature sensing and thermochronometry: Principles and fundamental challenges. RADIAT MEAS 2018. [DOI: 10.1016/j.radmeas.2018.05.007] [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] [Indexed: 10/16/2022]
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Green T, Davis C, Lambert R, Bird J. INCREASED REACTIVITY THRESHOLD IN PEANUT-ALLERGIC SUBJECTS TREATED WITH 12 MONTHS OF EPICUTANEOUS VIASKIN PEANUT. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.033] [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: 10/27/2022]
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Greenhawt M, Carr W, Davis C, Lieberman J, Mustafa S, Green T, Gramme P, Lambert R, Fleischer D. SERUM BIOMARKERS OF IMMUNOMODULATION DURING PEANUT EPICUTANEOUS IMMUNOTHERAPY (EPIT) IN PEANUT-ALLERGIC SUBJECTS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.035] [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: 10/27/2022]
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Lambert R, Grimshaw KEC, Ellis B, Jaitly J, Roberts G. Evidence that eating baked egg or milk influences egg or milk allergy resolution: a systematic review. Clin Exp Allergy 2017; 47:829-837. [PMID: 28516451 DOI: 10.1111/cea.12940] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It has been proposed that the frequent ingestion of baked hen's egg or cow's milk accelerates the resolution of hen's egg or cow's milk allergy. This practice is being introduced into clinical practice. OBJECTIVE To systematically review the evidence to determine whether the introduction of baked hen's egg or cow's milk into the diet of children with hen's egg or cow's milk allergies respectively leads to a larger proportion of children outgrowing these allergies than expected. METHODS A systematic review of the literature was conducted in Medline, Embase and CINAHL. The inclusion criteria were as follows: randomized control trials, case-control or cohort studies; children aged 0-18 years with hen's egg or cow's milk allergy; baked hen's egg or cow's milk intervention with or without a comparator; and resolution of the hen's egg or cow's milk allergy as determined by food challenge as the outcome. Studies were critically appraised using the quality assessment tool for quantitative studies. PROSPERO reference CRD42015026029. RESULTS We identified 851 and 2816 hen's egg and cow's milk articles respectively. Only three hen's egg and three cow's milk studies fulfilled our pre-specified inclusion criteria. The studies concluded that baked products either increased the likelihood of the resolution of allergy or accelerated resolution. However, when critiqued, all studies were classified as weak because they were observational, lacking an appropriate control group; this brings into doubt the study's conclusions. There were a number of examples of severe reactions to baked products. CONCLUSION There is little evidence to address the hypothesis that the ingestion of baked hen's egg or cow's milk results in more patients outgrowing their hen's egg or cow's milk allergy respectively. Data are required from a trial comparing the resolution rates of baked-tolerant participants who are randomized to ingest or avoid baked products to assess the accuracy of this hypothesis.
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Affiliation(s)
- R Lambert
- Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, UK
| | - K E C Grimshaw
- Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, UK.,NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - B Ellis
- Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, UK
| | - J Jaitly
- Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, UK
| | - G Roberts
- Clinical and Experimental Sciences and Human Development in Health Academic Units, University of Southampton, Southampton, UK.,NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, UK
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Darbos C, Magne R, Arnold A, Prinz HO, Thumm M, Bouquey F, Hogge JP, Lambert R, Lennholm M, Liévin C, Traisnel E. The 118-GHz Electron Cyclotron Heating System on Tore Supra. Fusion Science and Technology 2017. [DOI: 10.13182/fst09-a9174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C. Darbos
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - R. Magne
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - A. Arnold
- Unviversität Karlsruhe, Institut für Hochfrequenztechnik und Electronik, Karlsruhe, Germany
| | - H. O. Prinz
- Forschungszentrum Karlsruhe, Association Euratom-FZK, Institut für Hochleistungsimpuls- und Mikrowellentechnik Karlsruhe, Germany
| | - M. Thumm
- Unviversität Karlsruhe, Institut für Hochfrequenztechnik und Electronik, Karlsruhe, Germany
- Forschungszentrum Karlsruhe, Association Euratom-FZK, Institut für Hochleistungsimpuls- und Mikrowellentechnik Karlsruhe, Germany
| | - F. Bouquey
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - J. P. Hogge
- Association EURATOM-Confédération Suisse, Lausanne, Switzerland
| | - R. Lambert
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - M. Lennholm
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - C. Liévin
- Thales Electron Devices, Vélizy, France
| | - E. Traisnel
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
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Lennholm M, Eriksson LG, Turco F, Bouquey F, Darbos C, Dumont R, Giruzzi G, Jung M, Lambert R, Magne R, Molina D, Moreau P, Rimini F, Segui JL, Song S, Traisnel E. Closed Loop Sawtooth Period Control Using Variable ECCD Injection Angles on Tore Supra. Fusion Science and Technology 2017. [DOI: 10.13182/fst09-a4052] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Lennholm
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - L-G. Eriksson
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - F. Turco
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - F. Bouquey
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - C. Darbos
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - R. Dumont
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - G. Giruzzi
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - M. Jung
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - R. Lambert
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - R. Magne
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - D. Molina
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - P. Moreau
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - F. Rimini
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - J-L. Segui
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - S. Song
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
| | - E. Traisnel
- Association EURATOM-CEA DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
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Rougon-Motte V, Lambert R, Callens E, Baji S, Hilali N. Analyse des barrières de prévention par une approche systémique des risques par le modèle de James Reason sur base de la cartographie des processus. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.099] [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]
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Chantant M, Lambert R, Gargiulo L, Hatchressian JC, Guilhem D, Samaille F, Soler B. Leak tightness tests on actively cooled plasma facing components: Lessons learned from Tore Supra experience and perspectives for the new fusion machines. Fusion Engineering and Design 2015. [DOI: 10.1016/j.fusengdes.2015.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Allum WH, Bonavina L, Cassivi SD, Cuesta MA, Dong ZM, Felix VN, Figueredo E, Gatenby PAC, Haverkamp L, Ibraev MA, Krasna MJ, Lambert R, Langer R, Lewis MPN, Nason KS, Parry K, Preston SR, Ruurda JP, Schaheen LW, Tatum RP, Turkin IN, van der Horst S, van der Peet DL, van der Sluis PC, van Hillegersberg R, Wormald JCR, Wu PC, Zonderhuis BM. Surgical treatments for esophageal cancers. Ann N Y Acad Sci 2015; 1325:242-68. [PMID: 25266029 DOI: 10.1111/nyas.12533] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy.
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Affiliation(s)
- William H Allum
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
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Van Middelkoop M, Arden N, Atchia I, Birrell F, Chao J, Lambert R, Ravaud P, Bijlsma J, Doherty M, Dziedzic K, Lohmander S, McAlindon T, Zhang W, Bierma-Zeinstra S. SAT0429 The OA TRIAL Bank: Meta-Analysis of Individual Patient Data Show That Patients with Severe Pain or with Inflammatory Signs Detected by Ultrasound Especially Benefit from Intra-Articular Glucocorticoids for Knee or Hip Oa. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Andreoli JC, Lambert R. Colonoscopy in screening for colorectal cancer. Arq Gastroenterol 2014; 50:242-3. [PMID: 24474224 DOI: 10.1590/s0004-28032013000400001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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van der Heijde D, Maksymowych W, Sieper J, Lambert R, Brown MA, Rathmann S, Anderson J, Pangan AL. THU0361 Relationship between MRI and Clinical Remission in Patients with Non-Radiographic Axial Spondyloarthritis after Two Years of Adalimumab Therapy. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Maksymowych W, Weber U, Pianta M, Lambert R. SAT0335 Semi-quantitative assessment of bone marrow edema and synovitis-effusion in osteoarthritis with the knee inflammation MRI scoring system (KIMRISS): A target lesion based methodology:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3281] [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: 11/04/2022]
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Maksymowych W, Learch T, Lambert R, Ward M, Haroon N, Salonen D, Inman R, Weisman M. FRI0271 The SPARCC/SPARTAN (SPAR) reference imaging module for calibration of readers scoring with the msasss: Preliminary validation. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2728] [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: 11/04/2022]
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Maksymowych W, Weisman M, Lambert R, Haroon N, Inman R, Salonen D, Ward M, Learch T. FRI0297 What is the contribution of the antero-posterior radiograph of the lumbar spine to the assessment of radiographic severity and progression using the modified stoke ankylosing spondylitis spine score?:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2754] [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: 11/04/2022]
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Maksymowych W, Pedersen S, Østergaard M, Lambert R. OP0269 MRI of the spine for detection of new bone formation in ankylosing spondylitis: Does it offer any advantages over radiography?:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1952] [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: 11/04/2022]
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Abstract
Barrett's esophagus, or columnar metaplasia with gastric cardiac cells or intestinal cells, develops in the squamous epithelium of the esophageal mucosa in relation to gastroesophageal reflux. An increased risk of neoplasia justifies surveillance at regular intervals. Conventional guidelines recommend detection of areas with intestinal metaplasia or dysplasia by taking random four-quadrant biopsies at every 1 or 2 cm. Alternatively, image processing with narrow band imaging (NBI), is proposed to improve detection. This international and randomized study in persons with Barrett's esophagus compares conventional endoscopy in white light with random four-quadrant biopsies and NBI imaging with focused biopsies only. Randomization enrolled 123 patients with Barrett's esophagus who successively underwent exploration with the two methods. The study confirmed that NBI had the same efficacy as white light in the detection of intestinal metaplasia, with a higher proportion of dysplasia detected (30 vs 21%) and a lower number of biopsies per patient (3.6 vs 7.6).
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Affiliation(s)
- René Lambert
- Screening Group, International Agency for Research on Cancer, Lyon, France.
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22
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von Karsa L, Patnick J, Segnan N, Atkin W, Halloran S, Lansdorp-Vogelaar I, Malila N, Minozzi S, Moss S, Quirke P, Steele RJ, Vieth M, Aabakken L, Altenhofen L, Ancelle-Park R, Antoljak N, Anttila A, Armaroli P, Arrossi S, Austoker J, Banzi R, Bellisario C, Blom J, Brenner H, Bretthauer M, Camargo Cancela M, Costamagna G, Cuzick J, Dai M, Daniel J, Dekker E, Delicata N, Ducarroz S, Erfkamp H, Espinàs JA, Faivre J, Faulds Wood L, Flugelman A, Frkovic-Grazio S, Geller B, Giordano L, Grazzini G, Green J, Hamashima C, Herrmann C, Hewitson P, Hoff G, Holten I, Jover R, Kaminski MF, Kuipers EJ, Kurtinaitis J, Lambert R, Launoy G, Lee W, Leicester R, Leja M, Lieberman D, Lignini T, Lucas E, Lynge E, Mádai S, Marinho J, Maučec Zakotnik J, Minoli G, Monk C, Morais A, Muwonge R, Nadel M, Neamtiu L, Peris Tuser M, Pignone M, Pox C, Primic-Zakelj M, Psaila J, Rabeneck L, Ransohoff D, Rasmussen M, Regula J, Ren J, Rennert G, Rey J, Riddell RH, Risio M, Rodrigues V, Saito H, Sauvaget C, Scharpantgen A, Schmiegel W, Senore C, Siddiqi M, Sighoko D, Smith R, Smith S, Suchanek S, Suonio E, Tong W, Törnberg S, Van Cutsem E, Vignatelli L, Villain P, Voti L, Watanabe H, Watson J, Winawer S, Young G, Zaksas V, Zappa M, Valori R. European guidelines for quality assurance in colorectal cancer screening and diagnosis: overview and introduction to the full supplement publication. Endoscopy 2013; 45:51-9. [PMID: 23212726 PMCID: PMC4482205 DOI: 10.1055/s-0032-1325997] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010. They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines.
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Affiliation(s)
| | - L. von Karsa
- International Agency for Research on Cancer, Lyon, France
| | - J. Patnick
- NHS Cancer Screening Programmes Sheffield, United Kingdom,Oxford University Cancer Screening Research Unit, Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - N. Segnan
- International Agency for Research on Cancer, Lyon, France,CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - W. Atkin
- Imperial College London, London, United Kingdom
| | - S. Halloran
- Bowel Cancer Screening Southern Programme Hub, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom,University of Surrey, Guildford, United Kingdom
| | | | - N. Malila
- Finnish Cancer Registry, Helsinki, Finland
| | - S. Minozzi
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - S. Moss
- The Institute of Cancer Research, Royal Cancer Hospital, Sutton, United Kingdom
| | - P. Quirke
- Leeds Institute of Molecular Medicine, St James’ University Hospital, Leeds, United Kingdom
| | - R. J. Steele
- Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - M. Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
| | - L. Aabakken
- Department of Medical Gastroenterology, Stavanger University Hospital, Stavanger, Norway
| | - L. Altenhofen
- Central Research Institute of Ambulatory Health Care, Berlin, Germany
| | | | - N. Antoljak
- Croatian National Institute of Public Health, Zagreb, Croatia,University of Zagreb School of Medicine, Zagreb, Croatia
| | - A. Anttila
- Finnish Cancer Registry, Helsinki, Finland
| | - P. Armaroli
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | | | - J. Austoker
- University of Oxford, Oxford, United Kingdom
| | - R. Banzi
- Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - C. Bellisario
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - J. Blom
- Karolinska Institutet, Stockholm, Sweden
| | - H. Brenner
- German Cancer Research Center, Heidelberg, Germany
| | - M. Bretthauer
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - M. Camargo Cancela
- National Cancer Registry, Cork, Ireland,Formerly International Agency for Research on Cancer, Lyon, France
| | | | - J. Cuzick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom
| | - M. Dai
- Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - J. Daniel
- Formerly International Agency for Research on Cancer, Lyon, France,American Cancer Society, Atlanta, Georgia, United States of America
| | - E. Dekker
- Academic Medical Centre, Amsterdam, the Netherlands
| | - N. Delicata
- National Health Screening Services, Ministry of Health, Elderly & Community Care, Valletta, Malta
| | - S. Ducarroz
- International Agency for Research on Cancer, Lyon, France
| | - H. Erfkamp
- University of Applied Sciences FH Joanneum, Graz, Austria
| | - J. A. Espinàs
- Catalan Cancer Strategy, L’Hospitalet de Llobregat, Spain
| | - J. Faivre
- Digestive Cancer Registry of Burgundy, INSERM U866, University and CHU, Dijon, France
| | - L. Faulds Wood
- Lynn’s Bowel Cancer Campaign, Twickenham, United Kingdom
| | - A. Flugelman
- National Israeli Breast and Colorectal Cancer Detection, Haifa, Israel
| | - S. Frkovic-Grazio
- Department of Gynecological Pathology and Cytology, University Medical Center Ljubljana, Slovenia
| | - B. Geller
- University of Vermont, Burlington, Vermont, United States of America
| | - L. Giordano
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - G. Grazzini
- Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - J. Green
- University of Oxford, Oxford, United Kingdom
| | | | - C. Herrmann
- Formerly International Agency for Research on Cancer, Lyon, France,Cancer League of Eastern Switzerland, St. Gallen, Switzerland
| | - P. Hewitson
- University of Oxford, Oxford, United Kingdom
| | - G. Hoff
- Cancer Registry of Norway, Oslo, Norway,Telemark Hospital, Skien, Norway
| | - I. Holten
- Danish Cancer Society, Copenhagen, Denmark
| | - R. Jover
- Hospital General Universitario de Alicante, Alicante, Spain
| | - M. F. Kaminski
- Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland
| | | | | | - R. Lambert
- International Agency for Research on Cancer, Lyon, France
| | - G. Launoy
- U1086 INSERM – UCBN, CHU Caen, France
| | - W. Lee
- The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | | | - M. Leja
- University of Latvia, Riga, Latvia
| | - D. Lieberman
- Oregon Health & Science University, Portland, Oregon, United States of America
| | - T. Lignini
- International Agency for Research on Cancer, Lyon, France
| | - E. Lucas
- International Agency for Research on Cancer, Lyon, France
| | - E. Lynge
- University of Copenhagen, Copenhagen, Denmark
| | - S. Mádai
- MaMMa Healthcare Institute, Budapest, Hungary
| | - J. Marinho
- Health Administration Central Region Portugal, Aveiro, Portugal
| | | | - G. Minoli
- Gastroenterology Unit, Valduce Hospital, Como, Italy
| | - C. Monk
- GlaxoSmithKline Pharma Europe, London, United Kingdom
| | - A. Morais
- Regional Health Administration, Coimbra, Portugal
| | - R. Muwonge
- International Agency for Research on Cancer, Lyon, France
| | - M. Nadel
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - L. Neamtiu
- Prof. Dr Ion Chiricuţă, Cluj-Napoca, Romania
| | - M. Peris Tuser
- Catalan Institute of Oncology, L’Hospitalet de Llobregat, Spain
| | - M. Pignone
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - C. Pox
- Ruhr Universität, Bochum, Germany
| | - M. Primic-Zakelj
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Slovenia
| | - J. Psaila
- National Health Screening Services, Ministry of Health, Elderly & Community Care, Valletta, Malta
| | - L. Rabeneck
- University of Toronto and Cancer Care Ontario, Toronto, Canada
| | - D. Ransohoff
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Rasmussen
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - J. Regula
- Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland
| | - J. Ren
- Formerly International Agency for Research on Cancer, Lyon, France
| | - G. Rennert
- National Israeli Breast and Colorectal Cancer Detection, Haifa, Israel
| | - J. Rey
- Institut Arnault Tzanck, St Laurent du Var, France
| | | | - M. Risio
- Institute for Cancer Research and Treatment, Candiolo-Torino, Italy
| | - V. Rodrigues
- Faculdade de Medicina – Universidade de Coimbra, Coimbra, Portugal
| | - H. Saito
- National Cancer Centre, Tokyo, Japan
| | - C. Sauvaget
- International Agency for Research on Cancer, Lyon, France
| | | | | | - C. Senore
- CPO Piemonte, AO Città della Salute e della Scienza di Torino, Turin Italy
| | - M. Siddiqi
- Cancer Foundation of India, Kolkata, India
| | - D. Sighoko
- Formerly International Agency for Research on Cancer, Lyon, France,The University of Chicago, Department of Medicine, Hematology–Oncology Section, Center for Clinical Cancer Genetics, Global Health, Chicago, United States of America
| | - R. Smith
- American Cancer Society, Atlanta, Georgia, United States of America
| | - S. Smith
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - S. Suchanek
- Charles University and Military University Hospital, Prague, Czech Republic
| | - E. Suonio
- International Agency for Research on Cancer, Lyon, France
| | - W. Tong
- Chinese Academy of Medical Sciences, Beijing, China
| | - S. Törnberg
- Department of Cancer Screening, Stockholm Gotland Regional Cancer Centre, Stockholm, Sweden
| | | | - L. Vignatelli
- Agenzia Sanitaria e Sociale Regionale–Regione Emilia-Romagna, Bologna, Italy
| | - P. Villain
- University of Oxford, Oxford, United Kingdom
| | - L. Voti
- Formerly International Agency for Research on Cancer, Lyon, France,University of Miami, Miami, Florida, United States of America
| | | | - J. Watson
- University of Oxford, Oxford, United Kingdom
| | - S. Winawer
- Memorial Sloan–Kettering Cancer Center, New York, United States of America
| | - G. Young
- Gastrointestinal Services, Flinders University, Adelaide, Australia
| | - V. Zaksas
- State Patient Fund, Vilnius, Lithuania
| | - M. Zappa
- Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - R. Valori
- NHS Endoscopy, Leicester, United Kingdom
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23
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Abstract
The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett's esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of superficial capillaries; then characterization of the morphology of the lesion according to the Paris classification and prediction of the risk of malignancy and depth of invasion, with the help of chromoscopy, magnification and image processing with neutrophil bactericidal index or FICE. Then treatment decision offers 3 options according to histologic prediction: abstention, endoscopic resection, surgery. The rigorous quality control of endoscopy will reduce the miss rate of lesions and the occurrence of interval cancer.
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Affiliation(s)
- René Lambert
- René Lambert, World Health Organization International Agency for Research on Cancer, Screening Group, Lyon 69372, France
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24
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Vieth M, Quirke P, Lambert R, von Karsa L, Risio M. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Annotations of colorectal lesions. Endoscopy 2012; 44 Suppl 3:SE131-9. [PMID: 23012116 DOI: 10.1055/s-0032-1309798] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology was supplemented by an annex describing in greater detail some issues raised in the chapter, particularly details of special interest to pathologists. The content of the annex is presented here to promote international discussion and collaboration by making the issues discussed in the guidelines known to a wider professional and scientific community.
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Affiliation(s)
- M Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany.
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25
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Quirke P, Risio M, Lambert R, von Karsa L, Vieth M. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Quality assurance in pathology in colorectal cancer screening and diagnosis. Endoscopy 2012; 44 Suppl 3:SE116-30. [PMID: 23012115 DOI: 10.1055/s-0032-1309797] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in pathology in colorectal cancer screening and diagnosis includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease.
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Affiliation(s)
- P Quirke
- Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, United Kingdom.
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26
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Steele RJC, Pox C, Kuipers EJ, Minoli G, Lambert R. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Management of lesions detected in colorectal cancer screening. Endoscopy 2012; 44 Suppl 3:SE140-50. [PMID: 23012117 DOI: 10.1055/s-0032-1309802] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on management of lesions detected in colorectal cancer screening includes 32 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease.
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Affiliation(s)
- R J C Steele
- Ninewells Hospital and Medical School, Dundee, United Kingdom.
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27
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Steele RJC, Rey JF, Lambert R. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Professional requirements and training. Endoscopy 2012; 44 Suppl 3:SE106-15. [PMID: 23012114 DOI: 10.1055/s-0032-1309796] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on professional requirements and training includes 23 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of surveillance and other elements in the screening process, including multi-disciplinary diagnosis and management of the disease.
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Affiliation(s)
- R J C Steele
- Ninewells Hospital and Medical School, Dundee, United Kingdom.
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28
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Atkin WS, Valori R, Kuipers EJ, Hoff G, Senore C, Segnan N, Jover R, Schmiegel W, Lambert R, Pox C. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Colonoscopic surveillance following adenoma removal. Endoscopy 2012; 44 Suppl 3:SE151-63. [PMID: 23012119 DOI: 10.1055/s-0032-1309821] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on colonoscopic surveillance following adenoma removal includes 24 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of surveillance and other elements in the screening process, including multi-disciplinary diagnosis and management of the disease.
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Affiliation(s)
- W S Atkin
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
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29
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Valori R, Rey JF, Atkin WS, Bretthauer M, Senore C, Hoff G, Kuipers EJ, Altenhofen L, Lambert R, Minoli G. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition--Quality assurance in endoscopy in colorectal cancer screening and diagnosis. Endoscopy 2012; 44 Suppl 3:SE88-105. [PMID: 23012124 DOI: 10.1055/s-0032-1309795] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in endoscopy includes 50 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of endoscopy and other elements in the screening process, including multidisciplinary diagnosis and management of the disease.
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Affiliation(s)
- R Valori
- Gloucestershire Royal Hospital, Gloucester, United Kingdom.
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30
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Hale B, Evans L, Lambert R. Effects of cement or lime on Cd, Co, Cu, Ni, Pb, Sb and Zn mobility in field-contaminated and aged soils. J Hazard Mater 2012; 199-200:119-127. [PMID: 22138168 DOI: 10.1016/j.jhazmat.2011.10.065] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 09/26/2011] [Accepted: 10/23/2011] [Indexed: 05/31/2023]
Abstract
Cement or lime can be used to treat trace element contaminated soils, reducing their mobility due to increased soil pH which enhances precipitation and adsorption, and also due to pozzolanic reactions and cementation. In the present work, an alkaline and an acidic soil both containing Cd, Co, Cu, Ni, Pb, Sb and Zn from either geogenic or geogenic and anthropogenic origin were treated with cement or calcium hydroxide. Soils were then extracted with dilute HNO(3) or NaOH solution of different concentrations to obtain extracts of different pH (pH 4-12). In untreated soils, Co, Cu, Ni and Pb in solutions were detected at alkaline pH. The addition of cement or Ca(OH)(2) reduced the mobility of every trace element at high pH, but enhanced the mobility of Cd, Co, Cu, Ni, Pb and Zn at low pH. Metal mobilisation at high pH was observed for Cu in the acidic soil due to the liberation of dissolved organic matter. Below pH 6, Sb mobility was lower in the cement-treated soil compared to the untreated soil, but the same in the Ca(OH)(2) treated soil as in the control soil. Comparison with theoretical trace element precipitates suggested that the mobility of trace elements is likely reduced at high pH by encapsulation and immobilisation within the cement matrix rather then precipitation.
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Affiliation(s)
- Beverley Hale
- School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada.
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31
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Suzuki G, Mellander MR, Suzuki A, Rubio CA, Lambert R, Björk J, Schmidt PT. Usefulness of colonoscopic examination with indigo carmine in diagnosing microscopic colitis. Endoscopy 2011; 43:1100-4. [PMID: 22057822 DOI: 10.1055/s-0031-1291423] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Microscopic colitis, comprising collagenous colitis and lymphocytic colitis, is epitomized by chronic watery diarrhea, endoscopically normal colonic mucosa, and characteristic histopathological features. Reports on chromoendoscopic findings in microscopic colitis are scarce and in this paper we describe such findings. We have examined 13 patients with microscopic colitis by means of chromoendoscopy with indigo carmine 0.2 % - 0.5 %. In all 13 cases continuous mucosal changes were seen, with disappearance of innominate grooves or with irregularity of grooves. The segmental distribution of abnormal chromoendoscopic findings corresponded almost completely with the microscopic features. A diffuse mosaic pattern was found in five of 10 cases of collagenous colitis and in all three cases of lymphocytic colitis. Uneven surface was seen in four cases of collagenous colitis, one of collagenous colitis in remission, and one of lymphocytic colitis, and a nodular surface was recorded in five cases of collagenous colitis but in none of the lymphocytic colitis cases. If these findings can be reproduced in larger series of microscopic colitis cases, the need for biopsies as a diagnostic tool might be restricted to patients where chromoendoscopy shows clear mucosal changes, thereby saving costs and limiting possible complications associated with multiple biopsies.
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Affiliation(s)
- G Suzuki
- Department of Gastroenterology and Hepatology, Karolinska University Hospital, Stockholm, Sweden
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32
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Guilhem D, Samaille F, Bertrand B, Lipa M, Achard J, Agarici G, Argouarch A, Armitano A, Belo J, Bej Z, Berger-By G, Bouquey F, Brun C, Chantant M, E.Corbel, Delmas E, Delpech L, Doceul L, Ekedahl A, Faisse F, Fejoz P, Goletto C, Goniche M, Hatchressian J, Hillairet J, Houry M, Joanard J, Joubert P, Lambert R, Lombard G, Lyonne M, Madeleine S, Magne R, Marfisi L, Martinez A, Maury M, Missirlian M, Mollard P, Poli S, Portafaix C, Preynas M, Prou M, Raulin D, Rousset E, Saille A, Soler B, Thouvenin D, Verger J, Volpe D, Vulliez K, Zago B. Manufacturing process and tests of a Lower Hybrid Passive–Active Multijunction launcher for long pulse experiments on Tore-Supra. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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33
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Appelman HD, Umar A, Orlando RC, Sontag SJ, Nandurkar S, El-Zimaity H, Lanas A, Parise P, Lambert R, Shields HM. Barrett's esophagus: natural history. Ann N Y Acad Sci 2011; 1232:292-308. [DOI: 10.1111/j.1749-6632.2011.06057.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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34
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Velasco-Sanchez D, Dahdah N, Lambert R, Turpin S, Fournier A. 633 The right ventricle myocardial perfusion scintigraphy: Feasibility and expected values in children. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.525] [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: 11/25/2022] Open
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35
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Worthington T, Dunlop D, Casey A, Lambert R, Luscombe J, Elliott T. Serum procalcitonin, interleukin-6, soluble intercellular adhesin molecule-1 and IgG to short-chain exocellular lipoteichoic acid as predictors of infection in total joint prosthesis revision. Br J Biomed Sci 2011; 67:71-6. [PMID: 20669762 DOI: 10.1080/09674845.2010.11730294] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The diagnosis of prosthetic joint infection and its differentiation from aseptic loosening remains problematic. The definitive laboratory diagnostic test is the recovery of identical infectious agents from multiple intraoperative tissue samples; however, interpretation of positive cultures is often complex as infection is frequently associated with low numbers of commensal microorganisms, in particular the coagulase-negative staphylococci (CNS). In this investigation, the value of serum procalcitonin (PCT), interleukin-6 (IL-6) and soluble intercellular adhesion molecule-1 (sICAM-1) as predictors of infection in revision hip replacement surgery is assessed. Furthermore, the diagnostic value of serum IgG to short-chain exocellular lipoteichoic acid (sce-LTA) is assessed in patients with infection due to CNS. Presurgical levels of conventional serum markers of infection including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) is also established. Forty-six patients undergoing revision hip surgery were recruited with a presumptive clinical diagnosis of either septic (16 patients) or aseptic loosening (30 patients). The diagnosis was confirmed microbiologically and levels of serum markers were determined. Serum levels of IL-6 and sICAM-1 were significantly raised in patients with septic loosening (P = 0.001 and P = 0.0002, respectively). Serum IgG to sce-LTA was elevated in three out of four patients with infection due to CNS. In contrast, PCT was not found to be of value in differentiating septic and aseptic loosening. Furthermore, CRP, ESR and WBC were significantly higher (P = 0.0001, P = 0.0001 and P = 0.003, respectively) in patients with septic loosening. Serum levels of IL-6, sICAM-1 and IgG to sce-LTA may provide additional information to facilitate the diagnosis of prosthetic joint infection.
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Affiliation(s)
- T Worthington
- School of Life and Health Sciences, Aston University, UK.
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36
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Guilhem D, Bertrand B, Lipa M, Achard J, Agarici G, Argouarch A, Belo J, Bej Z, Berger-By G, Bouquey F, Brun C, Chantant M, Corbel E, Delmas E, Delpech L, Doceul L, Ekedahl A, Faisse F, Goniche M, Hatchressian J, Hillairet J, Houry M, Joanard J, Joubert P, Lambert R, Lombard G, Lyonne M, Madeleine S, Magne R, Marfisi L, Martinez A, Maury M, Missirlian M, Mollard P, Poli S, Portafaix C, Preynas M, Prou M, Raulin D, Rousset E, Samaille F, Saille A, Soler B, Thouvenin D, Verger J, Volpe D, Vulliez K, Zago B. Manufacturing process and tests of a lower hybrid passive active multi-junction launcher for long pulse experiments on Tore-Supra. Fusion Engineering and Design 2011. [DOI: 10.1016/j.fusengdes.2011.01.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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37
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Vieth M, Quirke P, Lambert R, von Karsa L, Risio M. Annex to Quirke et al. Quality assurance in pathology in colorectal cancer screening and diagnosis: annotations of colorectal lesions. Virchows Arch 2011; 458:21-30. [PMID: 21061132 PMCID: PMC3016168 DOI: 10.1007/s00428-010-0997-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 08/24/2010] [Indexed: 12/16/2022]
Abstract
Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document includes a chapter on pathology with pan-European recommendations which take into account the diversity and heterogeneity of health care systems across the EU. The present paper is based on the annex to the pathology chapter which attempts to describe in greater depth some of the issues raised in the chapter in greater depth, particularly details of special interest to pathologists. It is presented here to make the relevant discussion known to a wider scientific audience.
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Affiliation(s)
- Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Preuschwitzerstr. 101, 95445 Bayreuth, Germany.
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Quirke P, Risio M, Lambert R, von Karsa L, Vieth M. Quality assurance in pathology in colorectal cancer screening and diagnosis—European recommendations. Virchows Arch 2011; 458:1-19. [PMID: 21061133 PMCID: PMC3016207 DOI: 10.1007/s00428-010-0977-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 08/29/2010] [Accepted: 09/05/2010] [Indexed: 02/08/2023]
Abstract
In Europe, colorectal cancer is the most common newly diagnosed cancer and the second most common cause of cancer deaths, accounting for approximately 436,000 incident cases and 212,000 deaths in 2008. The potential of high-quality screening to improve control of the disease has been recognized by the Council of the European Union who issued a recommendation on cancer screening in 2003. Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document consists of ten chapters and an extensive evidence base. The content of the chapter dealing with pathology in colorectal cancer screening and diagnosis is presented here in order to promote international discussion and collaboration leading to improvements in colorectal cancer screening and diagnosis by making the principles and standards recommended in the new EU Guidelines known to a wider scientific community.
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Affiliation(s)
- Phil Quirke
- Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Mauro Risio
- Pathology Department, Institute for Cancer Research and Treatment, Turin, Italy
| | - René Lambert
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Lawrence von Karsa
- Quality Assurance Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Preuschwitzerstr. 101, 95445 Bayreuth, Germany
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Abstract
The classification of the endoscopic appearance of superficial neoplastic lesions of the digestive mucosa aims to evaluate the risk of progression to advanced neoplasia in 3° (low, intermediate, high) and to predict appropriate treatment and corresponding surveillance. The privileged position of endoscopy results from its double impact on prevention of digestive cancer through reduction in incidence after early detection and eradication of precursors; and through reduction of mortality after detection and treatment of cancer at an early and curable stage. However the efficacy of diagnostic endoscopy still requires improvement and quality control on the following points: (1) technology, with a generalized use of the recently introduced high-resolution endoscopes. (2) diagnosis of poorly visible nonpolypoid precursors: this applies to small depressed lesions and large slightly elevated or sessile serrated and non-serrated precursors, particularly in the proximal colon. (3) treatment and training in therapeutic endoscopy, including the most recent techniques of mucosal resection of nonpolypoid lesions.
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Lambert R. Accreditation in digestive endoscopy. Acta Gastroenterol Latinoam 2010; 40:278-282. [PMID: 21049772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- René Lambert
- International Agency for Research on Cancer (I.A.R.C), Lyon, France.
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41
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Villa-Gómez G, Hawes R, Lambert R, Saenz R, Maluf F, Bronstein M. [Interesting dates/novelities in web page]. Acta Gastroenterol Latinoam 2010; 40:172-177. [PMID: 20645567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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43
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Lambert R. P01-144 - A lifestyle intervention for panic disorder in primary care and an explanatory model. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70349-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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44
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Lambert R, Kudo SE, Vieth M, Allen JI, Fujii H, Fujii T, Kashida H, Matsuda T, Mori M, Saito H, Shimoda T, Tanaka S, Watanabe H, Sung JJ, Feld AD, Inadomi JM, O'Brien MJ, Lieberman DA, Ransohoff DF, Soetikno RM, Zauber A, Teixeira CR, Rey JF, Jaramillo E, Rubio CA, Van Gossum A, Jung M, Jass JR, Triadafilopoulos G. Pragmatic classification of superficial neoplastic colorectal lesions. Gastrointest Endosc 2009; 70:1182-99. [PMID: 19879563 DOI: 10.1016/j.gie.2009.09.015] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 09/21/2009] [Indexed: 12/12/2022]
Affiliation(s)
- René Lambert
- Screening Group, International Agency for Research on Cancer, Lyon, France
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Lambert R. [Colonoscopy: maximizing detection and characterization]. Gastroenterol Clin Biol 2009; 33:737-746. [PMID: 19683885 DOI: 10.1016/j.gcb.2009.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The endoscopic analysis of the colonic lumen with a flexible tube began around1960, at first with a gastrocamera, then with a fibrocolonoscope. After 1990, the electronic imaging brought a three points revolution with increased resolution of the image, transfer of the image on a television monitor giving access to multiple observers, electronic image processing. The recent colonoscopes have an increased resolution with more pixels in the Charged Coupled Device (CCD) sensor, a High Definition Television (HDTV) image and an electronic and/or optical zoom for magnification. Colonoscopy is now often performed in a similar environment to that of surgery. Therapeutic applications justify a strict strategy for endoscopic diagnosis. At first, detection of the lesion in standard vision, then characterization with the help of chromoscopy for the evaluation of morphology and with the help of magnification for the evaluation of the pit pattern. Then, comes the time for treatment decision between abstention, endoscopic resection or surgery. The legitimacy of the management is controlled in retrospective by the analysis of the tissue samples. Recent alternatives to colonoscopy (3D radiological imaging, colon capsule) should not invalidate the priority attributed to colonoscopy which associates treatment to the early detection of colorectal cancer and precursors.
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Affiliation(s)
- R Lambert
- Group of Screening, International Agency for Research on Cancer, 69372 Lyon cedex 08, France.
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46
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Abstract
Most developed countries insist on the prevention of colorectal cancer (CRC) and offer screening to the population. Mass screening is proposed to both sexes in the population aged 50 years or more. Colonoscopy is then offered to persons having a positive faecal occult blood test. This recommendation should not be diffused over the world without considering the distinct dimensions of the risk and resources in developed and developing countries. A national screening policy is legitimate in developed countries like Japan, South Korea, and in North America and Europe. On the other hand, a mass screening policy for CRC is not recommended in most developing countries. The limited amount of resources attributed to health care for cancer should concern other indications in the control of common cancers, particularly in the cervix or liver. Indeed the risk of CRC is very low in most regions of Africa, and in some countries of South America and Asia.
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Affiliation(s)
- René Lambert
- Screening Group, International Agency for Research on Cancer, Lyon, France.
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Lennholm M, Eriksson LG, Turco F, Bouquey F, Darbos C, Dumont R, Giruzzi G, Jung M, Lambert R, Magne R, Molina D, Moreau P, Rimini F, Segui JL, Song S, Traisnel E. Demonstration of effective control of fast-ion-stabilized sawteeth by electron-cyclotron current drive. Phys Rev Lett 2009; 102:115004. [PMID: 19392209 DOI: 10.1103/physrevlett.102.115004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Indexed: 05/27/2023]
Abstract
In a tokamak plasma, sawtooth oscillations in the central temperature, caused by a magnetohydrodynamic instability, can be partially stabilized by fast ions. The resulting less frequent sawtooth crashes can trigger unwanted magnetohydrodynamic activity. This Letter reports on experiments showing that modest electron-cyclotron current drive power, with the deposition positioned by feedback control of the injection angle, can reliably shorten the sawtooth period in the presence of ions with energies >or=0.5 MeV. Certain surprising elements of the results are evaluated qualitatively in terms of existing theory.
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Affiliation(s)
- M Lennholm
- Association EURATOM-CEA, DSM/IRFM, CEA/Cadarache, 13108 St. Paul-lez-Durance, France
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48
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Affiliation(s)
- R Lambert
- Screening Group, International Agency for Research on Cancer (IARC), Lyon, France.
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49
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50
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Kudo SE, Lambert R, Allen JI, Fujii H, Fujii T, Kashida H, Matsuda T, Mori M, Saito H, Shimoda T, Tanaka S, Watanabe H, Sung JJ, Feld AD, Inadomi JM, O'Brien MJ, Lieberman DA, Ransohoff DF, Soetikno RM, Triadafilopoulos G, Zauber A, Teixeira CR, Rey JF, Jaramillo E, Rubio CA, Van Gossum A, Jung M, Vieth M, Jass JR, Hurlstone PD. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc 2008; 68:S3-47. [PMID: 18805238 DOI: 10.1016/j.gie.2008.07.052] [Citation(s) in RCA: 338] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 07/30/2008] [Indexed: 02/08/2023]
Affiliation(s)
- Shin ei Kudo
- Digestive Disease Center, Northern Yokohama Hospital, Showa University, Yokohama, Japan
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