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Article: Limited Role of the Apparent Diffusion Coefficient (ADC) for Tumor Grade and Overall Survival in Resectable Pancreatic Ductal Adenocarcinoma.

Riviere, Deniece M / Maas, Marnix C / Brosens, Lodewijk A A / Stommel, Martijn W J / van Laarhoven, Cornelis J H M / Hermans, John J

Diagnostics (Basel, Switzerland)

2024 Volume 14, Issue 6

Abstract: This study evaluated the relationship between apparent diffusion coefficient (ADC) values in pancreatic ductal adenocarcinoma (PDAC) and tumor grades based on WHO, Adsay, and Kalimuthu classifications, using whole-mount pancreatectomy specimens. If ... ...

Abstract	This study evaluated the relationship between apparent diffusion coefficient (ADC) values in pancreatic ductal adenocarcinoma (PDAC) and tumor grades based on WHO, Adsay, and Kalimuthu classifications, using whole-mount pancreatectomy specimens. If glandular formation plays a key role in the degree of diffusion restriction, diffusion-weighted imaging could facilitate non-invasive grading of PDAC. A freehand region of interest (ROI) was drawn along tumor borders on the preoperative ADC map in each tumor-containing slice. Resection specimens were retrospectively graded according to WHO, Adsay, and Kalimuthu classifications and correlated with overall survival and the 10th percentile of whole-volume ADC values. Findings from 40 patients (23 male, median age 67) showed no correlation between ADC p10 values and WHO differentiation (
Language	English
Publishing date	2024-03-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14060573
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Article: Feasibility of Introducing a Prehabilitation Program into the Care of Gynecological Oncology Patients-A Single Institution Experience.

Dhanis, Joëlle / Strijker, Dieuwke / Drager, Luuk D / van Ham, Maaike / van Laarhoven, Cornelis J H M / Pijnenborg, Johanna M A / Smits, Anke / van den Heuvel, Baukje

Cancers

2024 Volume 16, Issue 5

Abstract: Prehabilitation is an upcoming strategy to optimize patient's functional capacity, nutritional status, and psychosocial well-being in order to reduce surgical complications and enhance recovery. This study aims to assess the feasibility of implementing a ...

Abstract	Prehabilitation is an upcoming strategy to optimize patient's functional capacity, nutritional status, and psychosocial well-being in order to reduce surgical complications and enhance recovery. This study aims to assess the feasibility of implementing a multimodal prehabilitation program into the standard care of gynecological oncology patients at an academic hospital in terms of recruitment, adherence, and safety, which were assessed by the number of patients eligible, recruitment rate, participation rate, and adherence to individual modalities. Data were derived from the F4S PREHAB trial, a single-center stepped-wedge trial implementing a multimodal prehabilitation program among various surgical specialties. All patients undergoing elective surgery as part of treatment for ovarian, uterine, and vulvar cancer at the Radboudumc, an academic hospital in The Netherlands, between May 2022 and September 2023 were considered eligible for the F4S PREHAB trial and, consequently, were included in this cohort study. The multimodal prehabilitation program comprised a physical exercise intervention, nutritional intervention, psychological intervention, and an intoxication cessation program. A total of 152 patients were eligible and approached for participation of which 111 consented to participate, resulting in a recruitment rate of 73%. Participants attended an average of six exercise sessions and adhered to 85% of possible training sessions. Respectively, 93% and 98% of participants adhered to the prescribed daily protein and vitamin suppletion. Ten participants were referred to a psychologist and completed consultations. Out of nine active smokers, two managed to quit smoking. A total of 59% adhered to alcohol cessation advice. No adverse events were reported. This study demonstrates that introducing a multimodal prehabilitation program into the standard care of gynecological oncology patients is feasible in terms of recruitment and adherence, with no serious adverse events.
Language	English
Publishing date	2024-02-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16051013
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Article: Patients with Clinically Suspected Gallstone Disease: A More Selective Ultrasound May Improve Treatment Related Outcomes.

Thunnissen, Floris M / Comes, Daan J / Geenen, Remy W F / Riviere, Deniece / Latenstein, Carmen S S / Lantinga, Marten A / Schers, Henk J / van Laarhoven, Cornelis J H M / Drenth, Joost P H / Atsma, Femke / de Reuver, Philip R

Journal of clinical medicine

2023 Volume 12, Issue 12

Abstract: This study aimed to quantify the confirmation of gallstones on ultrasound (US) in patients with suspicion of gallstone disease. To aid general practitioners (GPs) in diagnostic workup, a model to predict gallstones was developed. A prospective cohort ... ...

Abstract	This study aimed to quantify the confirmation of gallstones on ultrasound (US) in patients with suspicion of gallstone disease. To aid general practitioners (GPs) in diagnostic workup, a model to predict gallstones was developed. A prospective cohort study was conducted in two Dutch general hospitals. Patients (≥18 years) were eligible for inclusion when referred by GPs for US with suspicion of gallstones. The primary outcome was the confirmation of gallstones on US. A multivariable regression model was developed to predict the presence of gallstones. In total, 177 patients were referred with a clinical suspicion of gallstones. Gallstones were found in 64 of 177 patients (36.2%). Patients with gallstones reported higher pain scores (VAS 8.0 vs. 6.0,
Language	English
Publishing date	2023-06-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12124162
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Article ; Online: The Influence of Irreversible Electroporation Parameters on the Size of the Ablation Zone and Thermal Effects: A Systematic Review.

Hogenes, Annemiek M / Overduin, Christiaan G / Slump, Cornelis H / van Laarhoven, Cornelis J H M / Fütterer, Jurgen J / Ten Broek, Richard P G / Stommel, Martijn W J

Technology in cancer research & treatment

2023 Volume 22, Page(s) 15330338221125003

Abstract: Introduction: ...

Abstract	Introduction:
MeSH term(s)	Animals ; Electroporation/methods ; Ablation Techniques ; Temperature ; Linear Models ; Electroporation Therapies
Language	English
Publishing date	2023-01-04
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2146365-7
ISSN	1533-0338 ; 1533-0346
ISSN (online)	1533-0338
ISSN	1533-0346
DOI	10.1177/15330338221125003
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Article ; Online: Persistent and new-onset symptoms after cholecystectomy in patients with uncomplicated symptomatic cholecystolithiasis: A post hoc analysis of 2 prospective clinical trials.

Thunnissen, Floris M / Baars, Cléo / Arts, Rianne / Latenstein, Carmen S S / Drenth, Joost P H / van Laarhoven, Cornelis J H M / Lantinga, Marten A / de Reuver, Philip R

Surgery

2023 Volume 174, Issue 4, Page(s) 781–786

Abstract: Background: Laparoscopic cholecystectomy is the gold standard for treating biliary colic in patients with gallstones, but post-cholecystectomy abdominal pain is commonly reported. This study investigates which symptoms are likely to persist and which ... ...

Abstract	Background: Laparoscopic cholecystectomy is the gold standard for treating biliary colic in patients with gallstones, but post-cholecystectomy abdominal pain is commonly reported. This study investigates which symptoms are likely to persist and which may develop after a cholecystectomy. Methods: Patients from 2 previous prospective trials who underwent laparoscopic cholecystectomy for symptomatic cholecystolithiasis were included. Patients completed questionnaires on pain and gastrointestinal symptoms before surgery and at 6 months follow-up. The prevalence of persistent and new-onset abdominal symptoms was evaluated. Results: A total of 820 patients received cholecystectomy and were included, 75.4% female (n = 616/820) mean age 49.4 years (standard deviation 13.7). At baseline, 74.1% (n = 608/820) of patients met all criteria for biliary colic. Cholecystectomy successfully resolved biliary colic in 94.8% (n = 327/345) of patients, but 36.5% (n = 299/820) of patients reported persistent abdominal pain after 6 months of follow-up. The prevalence of most abdominal symptoms reduced significantly. Symptoms such as flatulence (17.8%, n = 146/820) or restricted eating (14.5%, n = 119/820) persisted most often. New-onset symptoms were frequent bowel movements (9.6%, n = 79/820), bowel urgency (8.5%, n = 70/820), and new-onset diarrhea (8.4%, 69/820). Conclusion: Postcholecystectomy symptoms are mainly flatulence, frequent bowel movements, and restricted eating. Newly reported symptoms are mainly frequent bowel movements, bowel urgency, and diarrhea. The present findings give clinical guidance in informing, managing, and treating patients with symptoms after cholecystectomy.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Colic/epidemiology ; Colic/etiology ; Colic/surgery ; Cholecystolithiasis/complications ; Cholecystolithiasis/surgery ; Flatulence/complications ; Flatulence/surgery ; Prospective Studies ; Cholecystectomy/adverse effects ; Abdominal Pain/diagnosis ; Abdominal Pain/epidemiology ; Abdominal Pain/etiology ; Cholecystectomy, Laparoscopic/adverse effects ; Gallbladder Diseases/surgery ; Diarrhea/etiology ; Bile Duct Diseases/surgery
Language	English
Publishing date	2023-08-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2023.06.010
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Article ; Online: A mixed-methods study to define Textbook Outcome for the treatment of patients with uncomplicated symptomatic gallstone disease with hospital variation analyses in Dutch trial data.

Thunnissen, Floris M / Comes, Daan J / Latenstein, Carmen S S / Stommel, Martijn W J / van Laarhoven, Cornelis J H M / Drenth, Joost P H / Lantinga, Marten A / Atsma, Femke / de Reuver, Philip R

HPB : the official journal of the International Hepato Pancreato Biliary Association

2023 Volume 25, Issue 9, Page(s) 1000–1010

Abstract: Background: International consensus on the ideal outcome for treatment of uncomplicated symptomatic gallstone disease is absent. This mixed-method study defined a Textbook Outcome (TO) for this large group of patients.: Methods: First, expert ... ...

Abstract	Background: International consensus on the ideal outcome for treatment of uncomplicated symptomatic gallstone disease is absent. This mixed-method study defined a Textbook Outcome (TO) for this large group of patients. Methods: First, expert meetings were organised with stakeholders to design the survey and identify possible outcomes. To reach consensus, results from expert meetings were converted in a survey for clinicians and for patients. During the final expert meeting, clinicians and patients discussed survey outcomes and a definitive TO was formulated. Subsequently, TO-rate and hospital variation were analysed in Dutch hospital data from patients with uncomplicated gallstone disease. Results: First expert meetings returned 32 outcomes. Outcomes were distributed in a survey among 830 clinicians from 81 countries and 645 Dutch patients. Consensus-based TO was defined as no more biliary colic, no biliary and surgical complications, and the absence or reduction of abdominal pain. Analysis of individual patient data showed that TO was achieved in 64.2% (1002/1561). Adjusted-TO rates showed modest variation between hospitals (56.6-74.9%). Conclusion: TO for treatment of uncomplicated gallstone disease was defined as no more biliary colic, no biliary and surgical complications, and absence or reduction of abdominal pain.TO may optimise consistent outcome reporting in care and guidelines for treating uncomplicated gallstone disease.
MeSH term(s)	Humans ; Colic ; Gallstones/diagnosis ; Gallstones/surgery ; Cholecystectomy/adverse effects ; Cholecystectomy, Laparoscopic/adverse effects ; Abdominal Pain ; Gallbladder Diseases/surgery
Language	English
Publishing date	2023-05-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2023.05.005
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Article ; Online: Corrigendum to 'A mixed-methods study to define Textbook Outcome for the treatment of patients with uncomplicated symptomatic gallstone disease with hospital variation analyses in Dutch trial data' [Volume 25, Issue 9, September 2023, Pages 1000-1010].

Thunnissen, Floris M / Comes, Daan J / Latenstein, Carmen S S / Stommel, Martijn W J / van Laarhoven, Cornelis J H M / Drenth, Joost P H / Lantinga, Marten A / Atsma, Femke / de Reuver, Philip R

HPB : the official journal of the International Hepato Pancreato Biliary Association

2023 Volume 26, Issue 2, Page(s) 321

Language	English
Publishing date	2023-11-18
Publishing country	England
Document type	Published Erratum
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2023.11.006
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Article ; Online: The Association Between Cholecystectomy, Metabolic Syndrome, and Nonalcoholic Fatty Liver Disease: A Population-Based Study.

Latenstein, Carmen S S / Alferink, Louise J M / Darwish Murad, Sarwa / Drenth, Joost P H / van Laarhoven, Cornelis J H M / de Reuver, Philip R

Clinical and translational gastroenterology

2020 Volume 11, Issue 4, Page(s) e00170

Abstract: Objectives: Obesity is a risk factor for several phenotypes such as gallstones, metabolic syndrome (MS), and nonalcoholic fatty liver disease (NAFLD). It has been suggested that cholecystectomy is a risk factor for metabolic abnormalities and NAFLD. We ... ...

Abstract	Objectives: Obesity is a risk factor for several phenotypes such as gallstones, metabolic syndrome (MS), and nonalcoholic fatty liver disease (NAFLD). It has been suggested that cholecystectomy is a risk factor for metabolic abnormalities and NAFLD. We aimed to determine whether cholecystectomy is associated with MS or NAFLD in a Dutch population-based study. Methods: The Rotterdam Study is an ongoing prospective population-based cohort. We included participants who underwent a liver ultrasound between 2009 and 2014 to assess steatosis. The prevalence of MS and NAFLD was calculated, and we performed regression analyses relating cholecystectomy with MS and NAFLD and adjusted for age, sex, study cohort, education level, physical activity, energy intake, time since cholecystectomy, body mass index, presence of hypertension, diabetes mellitus, and steatosis/MS. Results: We included 4,307 participants (57.5% women, median age 66.0 years [interquartile range 58-74]). In total, 265 participants (6.2%) underwent a cholecystectomy. The median age at the time of cholecystectomy was 57.0 years (47.5-66.5), and the median time from cholecystectomy to imaging of the liver was 10.0 years (0.5-19.5). The prevalence of MS in participants with cholecystectomy was 67.2% and 51.9% in participants without cholecystectomy (P < 0.001). Ultrasound diagnosed moderate/severe NAFLD was present in, respectively, 42.7% and 34.2% of the participants (P = 0.008). After multivariable adjustments for metabolic factors, cholecystectomy was no longer associated with the presence of MS or NAFLD. Discussion: The prevalence of MS and NAFLD is higher in participants after cholecystectomy. However, our trial shows that cholecystectomy may not be independently associated with the presence of MS and NAFLD after correction for metabolic factors.
MeSH term(s)	Aged ; Body Mass Index ; Cholecystectomy/adverse effects ; Confounding Factors, Epidemiologic ; Female ; Humans ; Liver/diagnostic imaging ; Male ; Metabolic Syndrome/epidemiology ; Metabolic Syndrome/etiology ; Middle Aged ; Netherlands ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/etiology ; Prevalence ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Ultrasonography
Language	English
Publishing date	2020-07-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2581516-7
ISSN	2155-384X ; 2155-384X
ISSN (online)	2155-384X
ISSN	2155-384X
DOI	10.14309/ctg.0000000000000170
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Article ; Online: Healthcare utilisation of patients with cholecystolithiasis in primary care: a multipractice comparative analysis.

Thunnissen, Floris Martijn / Drager, Luuk David / Braak, Breg / Drenth, Joost P H / van Laarhoven, Cornelis J H M / Schers, Henk J / de Reuver, Philip R

BMJ open

2021 Volume 11, Issue 11, Page(s) e053188

Abstract: Objectives: To examine general practitioners' (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis.: Design: Retrospective analysis of registry data and a subset of individual medical ...

Abstract	Objectives: To examine general practitioners' (GP) management of cholecystolithiasis and to evaluate persisting abdominal complaints in the years after the diagnosis. Design: Retrospective analysis of registry data and a subset of individual medical records. Setting: Seventeen primary care practices affiliated with the Radboudumc Practice Based Research Network in the Netherlands. Participants: 633 patients with cholecystolithiasis diagnosed between 2012 and 2016. Primary and secondary outcome measures: The primary outcome of this study was the healthcare utilisation of patients with cholecystolithiasis diagnosed by the GP in terms of referrals to secondary care, laboratory diagnostics, prescribed medication and the prevalence of concomitant abdominal-related diagnoses in a time interval of 3 years before and 3 years after diagnosis of cholecystolithiasis. For secondary outcomes, electronic medical records were studied from seven practices to assess emergency department visits, operation rates and repeat visits for persistent abdominal symptoms. We compared the non-referred group with the referred group. Results: In 57% of patients, concomitant abdominal-related diagnoses were recorded besides the diagnosis cholecystolithiasis. In-depth analyses of 294 patients showed a referral rate of 79.3% (n=233); 62.9% (n=185) underwent cholecystectomy. After referral, 55.4% (129/233) returned to the GP for persistent abdominal symptoms. Patients returning after referral were more often treated for another abdominal-related diagnosis before cholecystolithiasis was recorded (51.9% vs 28.8%, p<0.001). Conclusions: The majority of patients in general practice with gallstones are referred and undergo cholecystectomy. Patients with concomitant abdominal-related diagnoses are likely to return to their physician. GPs should inform patients about these outcomes to improve the shared decision-making process before gallbladder surgery.
MeSH term(s)	Gallstones ; General Practitioners ; Humans ; Patient Acceptance of Health Care ; Primary Health Care ; Retrospective Studies
Language	English
Publishing date	2021-11-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-053188
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Article ; Online: Imaging based flowchart for gallbladder polyp evaluation.

Wennmacker, Sarah Z / de Savornin Lohman, Elise A J / de Reuver, Philip R / Drenth, Joost P H / van der Post, Rachel S / Nagtegaal, Iris D / Hermans, John J / van Laarhoven, Cornelis J H M

Journal of medical imaging and radiation sciences

2021 Volume 52, Issue 1, Page(s) 68–78

Abstract: Background: Preoperative differentiation between neoplastic and nonneoplastic gallbladder polyps, and the subsequent indication for cholecystectomy remains a clinical dilemma. The current 1 cm size threshold for neoplasia is unspecific. The aim of this ... ...

Abstract	Background: Preoperative differentiation between neoplastic and nonneoplastic gallbladder polyps, and the subsequent indication for cholecystectomy remains a clinical dilemma. The current 1 cm size threshold for neoplasia is unspecific. The aim of this study was to improve diagnostic work-up for gallbladder polyps using sonographic and MRI characteristics of neoplastic and nonneoplastic polyps. Methods: A prospective, exploratory study including patients undergoing cholecystectomy for gallbladder polyp(s) was conducted. Patients underwent targeted transabdominal ultrasound (TAUS) and MRI. Outcomes were sensitivity and specificity for polyp diagnosis, and the radiological characteristics of neoplastic and nonneoplastic polyp types. Histopathology after cholecystectomy was used as reference standard. Results: Histopathology demonstrated gallbladder polyps in 20/27 patients (74%): 14 cholesterol polyps, three adenomyomatosis, two adenomas and one gastric heterotopia. Sensitivity of polyp identification were 72% (routine TAUS) and 86% (targeted TAUS and MRI). Both adenomas were identified as neoplastic on targeted TAUS and MRI. Sonographic presentation as multiple, pedunculated polyps, either heterogeneous or with hyperechoic foci, or as single polyps containing cysts were limited to nonneoplastic polyps. On MRI hyperintense polyps on T1-weighted image were cholesterol polyps. An adenoma with high-grade dysplasia showed foci of decreased ADC values. We propose a checklist for polyp evaluation by targeted TAUS and a flowchart for radiological work-up of gallbladder polyps. Conclusions: The presented checklist and flowchart could aid diagnostic work-up for gallbladder polyps compared to current routine ultrasound, by elimination of nonneoplastic polyps and ultimately improve treatment decision for patients with gallbladder polyps.
MeSH term(s)	Cholecystectomy ; Contrast Media ; Female ; Gallbladder Diseases/diagnostic imaging ; Gallbladder Diseases/pathology ; Gallbladder Diseases/surgery ; Humans ; Image Interpretation, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Meglumine ; Middle Aged ; Netherlands ; Organometallic Compounds ; Polyps/diagnostic imaging ; Polyps/pathology ; Polyps/surgery ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography
Chemical Substances	Contrast Media ; Organometallic Compounds ; Meglumine (6HG8UB2MUY) ; gadoterate meglumine (L0ND3981AG)
Language	English
Publishing date	2021-01-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2426513-5
ISSN	1876-7982 ; 1939-8654
ISSN (online)	1876-7982
ISSN	1939-8654
DOI	10.1016/j.jmir.2020.12.003
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