183 results on '"Midthun, David E."'
Search Results
152. Computed Tomographic Screening for Lung Cancer.
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Young, Robert P., Hopkins, Raewyn J., Midthun, David E., and Bach, Peter B.
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TOMOGRAPHY , *LUNG cancer - Abstract
A letter to the editor is presented in response to the article "Benefits and harms of CT screening for lung cancer" by Peter B. Bach and colleagues in the 2012 issue and response from the author is also presented.
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- 2012
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153. Are airflow obstruction and radiographic evidence of emphysema risk factors for lung cancer? A nested case-control study using quantitative emphysema analysis.
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Maldonado F, Bartholmai BJ, Swensen SJ, Midthun DE, Decker PA, Jett JR, Maldonado, Fabien, Bartholmai, Brian J, Swensen, Stephen J, Midthun, David E, Decker, Paul A, and Jett, James R
- Abstract
Objectives: Several studies have identified airflow obstruction as a risk factor for lung cancer independent of smoking history, but the risk associated with the presence of radiographic evidence of emphysema has not been extensively studied. We proposed to assess this risk using a quantitative volumetric CT scan analysis.Methods: Sixty-four cases of lung cancer were identified from a prospective cohort of 1,520 participants enrolled in a spiral CT scan lung cancer screening trial. Each case was matched to six control subjects for age, sex, and smoking history. Quantitative CT scan analysis of emphysema was performed. Spirometric measures were also conducted. Data were analyzed using conditional logistic regression making use of the 1:6 set groups of 64 cases and 377 matched control subjects.Results: Decreased FEV(1) and FEV(1)/FVC were significantly associated with a diagnosis of lung cancer with ORs of 1.15 (95% CI, 1.00-1.32; P = .046) and 1.29 (95% CI, 1.02-1.62; P = .031), respectively. The quantity of radiographic evidence of emphysema was not found to be a significant risk for lung cancer with OR of 1.042 (95% CI, 0.816-1.329; P = .743). Additionally, there was no significant association between severe emphysema and lung cancer with OR of 1.57 (95% CI, 0.73-3.37).Conclusions: We confirm previous observations that airflow obstruction is an independent risk factor for lung cancer. The absence of a clear relationship between radiographic evidence of emphysema and lung cancer using an automated quantitative volumetric analysis may result from different population characteristics than those of prior studies, radiographic evidence of emphysema quantitation methodology, or absence of any relationship between emphysema and lung cancer risk. [ABSTRACT FROM AUTHOR]- Published
- 2010
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154. 5-year lung cancer screening experience: growth curves of 18 lung cancers compared to histologic type, CT attenuation, stage, survival, and size.
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Lindell RM, Hartman TE, Swensen SJ, Jett JR, Midthun DE, Mandrekar JN, Lindell, Rebecca M, Hartman, Thomas E, Swensen, Stephen J, Jett, James R, Midthun, David E, and Mandrekar, Jayawant N
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Background: Although no study has prospectively documented the rate at which lung cancers grow, many have assumed exponential growth. The purpose of this study was to document the growth of lung cancers detected in high-risk participants receiving annual screening chest CT scans.Methods: Eighteen lung cancers were evaluated by at least four serial CT scans (4 men, 14 women; age range, 53 to 79 years; mean age, 66 years). CT scans were retrospectively reviewed for appearance, size, and volume (volume [v] = pi/6[ab(2)]). Growth curves (x = time [in days]; y = volume [cubic millimeters]) were plotted and subcategorized by histology, CT scan attenuation, stage, survival, and initial size.Results: Inclusion criteria favored smaller, less aggressive cancers. Growth curves varied, even when subcategorized by histology, CT scan attenuation, stage, survival, or initial size. Cancers associated with higher stages, mortality, or recurrence showed fairly steady growth or accelerated growth compared with earlier growth, although these growth patterns also were seen in lesser-stage lung cancers. Most lung cancers enlarged at fairly steady increments, but several demonstrated fairly flat growth curves, and others demonstrated periods of accelerated growth.Conclusions: This study is the first to plot individual lung cancer growth curves. Although parameters favored smaller, less aggressive cancers in women, it showed that lung cancers are not limited to exponential growth. Tumor size at one point or growth between two points did not appear to predict future growth. Studies and equations assuming exponential growth may potentially misrepresent an indeterminate nodule or the aggressiveness of a lung cancer. [ABSTRACT FROM AUTHOR]- Published
- 2009
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155. Contributors
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Albert, Richard K., Allen, Mark S., Atwood, Charles W., Aubry, Marie Christine, Barker, Alan F., Barnes, Peter J., Benfield, Thomas, Birring, Surinder S., Bolliger, Chris T., Brander, Lukas, Brower, Roy G., Brown, Jeremy, Bull, Todd M., Camus, Philippe, Carlsten, Christopher, Cassivi, Stephen D., Chan-Yeung, Moira, Chia, Jessica Y., Chow, Chung-Wai, Colby, Thomas V., Coldren, Christopher D., Cordier, Jean-François, Costabel, Ulrich, Cottin, Vincent, Criner, Gerard J., Culver, Bruce H., Daley, Charles L., Davies, Helen E., Decramer, Marc, Deschamps, Claude, Diacon, Andreas H., Dooms, Christophe, Dougherty, Ryan H., Douglas, Neil J., Downey, Gregory P., Evans, Scott E., Evans, Timothy W., Fitting, Jean-William, Folz, Rodney J., Garrity, Edward R., Jr, Gehlbach, Brian K., Geraci, Mark W., Gosselink, Rik, Brigitte Gottschall, E., Gruber, Michael P., Grutters, J.C., Hall, Jesse B., Hansell, David M., Hansra, Inderjit K., Herth, Felix J.F., Hill, Nicholas S., Hines, Stella E., Hubbard, Richard, Huchon, Gérard J., Hudson, Leonard D., Hurst, John R., Iannuzzi, Michael C., Jett, James R., Kaufman, Joel D., Kim, Victor, Koegelenberg, Coenraad F.N., Kreit, John W., Krowka, Michael J., Langer, Daniel, Lapinsky, Stephen E., Lazarus, Stephen C., Gary Lee, Y.C., Leroy, Sylvie, Lipman, Marc C.I., MacNee, William, Malo, Jean-Luc, M. McGhan, Ryan, McKinley, Sarah, Midthun, David E., Miller, Robert F., Moraes, Theo J., Myers, Jeffrey L., Neff, Margaret J., Newman, Lee S., Olson, Eric J., Padley, Simon P.G., Partridge, Martyn R., Pavord, Ian D., Porter, Joanna C., Rabbat, Antoine, Ratjen, Felix, Reed, Anna K., Rosado-de-Christenson, Melissa L., Rose, Cecile S., Roussos, Charis, Ruiz, Luis G., Ryu, Jay H., Scadding, Glenis K., Scanlon, Paul D., Schane, Rebecca E., Schwarz, Marvin I., Sebastian, Fabian, Sevransky, Jonathan E., Shah, Lori, Shaw, Penny, W. Shimabukuro, David, Sietsema, Kathy E., Simonds, Anita K., Slutsky, Arthur S., Spiro, Stephen G., Sterman, Daniel H., Stinson, Kaylan E., Strollo, Diane C., Strollo, Patrick J., Jr, Sue, Darryl Y., Teirstein, Alvin S., Torres, Antoni, Troosters, Thierry, Tullis, Elizabeth, Vachani, Anil, Valencia, Mauricio, van den Bosch, J.M.M., Vansteenkiste, Johan, Vassilakopoulos, Theodoros, Wallaert, Benoit, Wedzicha, Jadwiga A., Wells, Athol, White, Dorothy A., Wiener-Kronish, Jeanine P., Woodhead, Mark A., Woodruff, Prescott G., Wort, Stephen J., and Wynants, Jokke
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156. Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
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Gould, Michael K., Donington, Jessica, Lynch, William R., Mazzone, Peter J., Midthun, David E., Naidich, David P., and Wiener, Renda Soylemez
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LUNG cancer , *LUNG diseases , *DIAGNOSIS , *NODULAR disease - Abstract
Objectives The objective of this article is to update previous evidence-based recommendations for evaluation and management of individuals with solid pulmonary nodules and to generate new recommendations for those with nonsolid nodules. Methods We updated prior literature reviews, synthesized evidence, and formulated recommendations by using the methods described in the “Methodology for Development of Guidelines for Lung Cancer” in the American College of Chest Physicians Lung Cancer Guidelines, 3rd ed. Results We formulated recommendations for evaluating solid pulmonary nodules that measure > 8 mm in diameter, solid nodules that measure ≤ 8 mm in diameter, and subsolid nodules. The recommendations stress the value of assessing the probability of malignancy, the utility of imaging tests, the need to weigh the benefits and harms of different management strategies (nonsurgical biopsy, surgical resection, and surveillance with chest CT imaging), and the importance of eliciting patient preferences. Conclusions Individuals with pulmonary nodules should be evaluated and managed by estimating the probability of malignancy, performing imaging tests to better characterize the lesions, evaluating the risks associated with various management alternatives, and eliciting their preferences for management. [ABSTRACT FROM AUTHOR]
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- 2013
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157. Diagnostic Yield of 16S Ribosomal Ribonucleic Acid Gene-Based Targeted Metagenomic Sequencing for Evaluation of Pleural Space Infection: A Prospective Study.
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Gimenez-Miranda L, Samhouri BF, Wolf MJ, Anderson DK, Midthun DE, Lim KG, Kern RM, Patel R, and Carmona EM
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Objective: To better understand the microbial profile of complicated parapneumonic effusions and empyema, and to evaluate whether antimicrobial selection would differ if guided by targeted metagenomic sequencing (tMGS) vs conventional cultures (CCs) alone., Patients and Methods: We analyzed the pleural fluid of a cohort of 47 patients undergoing thoracentesis from January 1, 2017 to August 31, 2019, to characterize their microbial profile. All samples underwent 16S ribosomal ribonucleic acid gene polymerase chain reaction, followed by tMGS., Results: Pleural space infection was deemed clinically present in 20 of the 47 (43%) participants. Of those, n=7 (35%) had positive pleural fluid cultures and n=14 (70%) had positive tMGS results. The organisms identified by tMGS were concordant with CCs; however, tMGS detected additional bacterial species over CCs alone. Streptococcus and Staphylococcus species were the most common organisms identified, with Streptococcus intermedius/constellatus identified in 5 patients . Polymicrobial infections were found in 6 of the 20 patients, with anaerobes being the most common organisms identified in these cases., Conclusion: Streptococci and staphylococci were the most common organisms identified in infected pleural fluid. Anaerobes were common in polymicrobial infections. When compared with CCs, tMGS had higher sensitivity than CCs. Targeted metagenomic sequencing identified additional organisms, not identified by CCs, with associated potential management implications., Competing Interests: Dr Patel reports receiving grants from ContraFect, TenNor Therapeutics Limited, and BioFire. Dr Patel is a consultant for PhAST, Torus Biosystems, Day Zero Diagnostics, Mammoth Biosciences, and HealthTrackRx; monies are paid to Mayo Clinic. Mayo Clinic and Dr Patel have a relationship with Pathogenomix. Dr Patel has research supported by Adaptive Phage Therapeutics. Mayo Clinic has a royalty-bearing know-how agreement and equity in Adaptive Phage Therapeutics. Dr Patel is also a consultant for Netflix, Abbott Laboratories, Oxford Nanopore Technologies, and CARB-X. In addition, Dr Patel has a patent on Bordetella pertussis/parapertussis PCR issued, a patent on a device/method for sonication, with royalties paid by Samsung to Mayo Clinic, and a patent on an anti-biofilm substance issued. Dr Patel receives honoraria from the NBME, Up-to-Date and the Infectious Diseases Board Review Course. Dr Samhouri reports providing consultation (unpaid) to AI Therapeutics that is unrelated to the submitted work. Dr Carmona reports providing consultation to Boehringer Ingelheim for sarcoidosis that is unrelated to the submitted work., (© 2023 The Authors.)
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- 2023
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158. Bronchoscopy in the Critically Ill: Yes, No, Maybe?
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Bauer PR and Midthun DE
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- Humans, Intensive Care Units, Bronchoscopy, Critical Illness therapy
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- 2023
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159. Respiratory mucosal immunity against SARS-CoV-2 after mRNA vaccination.
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Tang J, Zeng C, Cox TM, Li C, Son YM, Cheon IS, Wu Y, Behl S, Taylor JJ, Chakaraborty R, Johnson AJ, Shiavo DN, Utz JP, Reisenauer JS, Midthun DE, Mullon JJ, Edell ES, Alameh MG, Borish L, Teague WG, Kaplan MH, Weissman D, Kern R, Hu H, Vassallo R, Liu SL, and Sun J
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- Humans, Immunity, Mucosal, SARS-CoV-2, Spike Glycoprotein, Coronavirus, Antibodies, Viral, RNA, Messenger, COVID-19 Vaccines, Vaccination, Respiratory System, Antibodies, Neutralizing, Viral Vaccines genetics, COVID-19 prevention & control
- Abstract
SARS-CoV-2 mRNA vaccination induces robust humoral and cellular immunity in the circulation; however, it is currently unknown whether it elicits effective immune responses in the respiratory tract, particularly against variants of concern (VOCs), including Omicron. We compared the SARS-CoV-2 S-specific total and neutralizing antibody responses, and B and T cell immunity, in the bronchoalveolar lavage fluid (BAL) and blood of COVID-19-vaccinated individuals and hospitalized patients. Vaccinated individuals had significantly lower levels of neutralizing antibody against D614G, Delta (B.1.617.2), and Omicron BA.1.1 in the BAL compared with COVID-19 convalescents despite robust S-specific antibody responses in the blood. Furthermore, mRNA vaccination induced circulating S-specific B and T cell immunity, but in contrast to COVID-19 convalescents, these responses were absent in the BAL of vaccinated individuals. Using a mouse immunization model, we demonstrated that systemic mRNA vaccination alone induced weak respiratory mucosal neutralizing antibody responses, especially against SARS-CoV-2 Omicron BA.1.1 in mice; however, a combination of systemic mRNA vaccination plus mucosal adenovirus-S immunization induced strong neutralizing antibody responses not only against the ancestral virus but also the Omicron BA.1.1 variant. Together, our study supports the contention that the current COVID-19 vaccines are highly effective against severe disease development, likely through recruiting circulating B and T cell responses during reinfection, but offer limited protection against breakthrough infection, especially by the Omicron sublineage. Hence, mucosal booster vaccination is needed to establish robust sterilizing immunity in the respiratory tract against SARS-CoV-2, including infection by the Omicron sublineage and future VOCs.
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- 2022
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160. NCCN Guidelines® Insights: Lung Cancer Screening, Version 1.2022.
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Wood DE, Kazerooni EA, Aberle D, Berman A, Brown LM, Eapen GA, Ettinger DS, Ferguson JS, Hou L, Kadaria D, Klippenstein D, Kumar R, Lackner RP, Leard LE, Lennes IT, Leung ANC, Mazzone P, Merritt RE, Midthun DE, Onaitis M, Pipavath S, Pratt C, Puri V, Raz D, Reddy C, Reid ME, Sandler KL, Sands J, Schabath MB, Studts JL, Tanoue L, Tong BC, Travis WD, Wei B, Westover K, Yang SC, McCullough B, and Hughes M
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- Humans, Mass Screening, Early Detection of Cancer, Lung Neoplasms diagnosis
- Abstract
The NCCN Guidelines for Lung Cancer Screening recommend criteria for selecting individuals for screening and provide recommendations for evaluation and follow-up of lung nodules found during initial and subsequent screening. These NCCN Guidelines Insights focus on recent updates to the NCCN Guidelines for Lung Cancer Screening.
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- 2022
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161. Correction to: Characterizing phenotypic abnormalities associated with high-risk individuals developing lung cancer using electronic health records from the All of Us researcher workbench.
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Na J, Zong N, Wang C, Midthun DE, Luo Y, Yang P, and Jiang G
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- 2022
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162. Characterizing phenotypic abnormalities associated with high-risk individuals developing lung cancer using electronic health records from the All of Us researcher workbench.
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Na J, Zong N, Wang C, Midthun DE, Luo Y, Yang P, and Jiang G
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- Early Detection of Cancer, Electronic Health Records, Genome-Wide Association Study, Humans, Phenotype, Lung Neoplasms epidemiology, Population Health
- Abstract
Objective: The study sought to test the feasibility of conducting a phenome-wide association study to characterize phenotypic abnormalities associated with individuals at high risk for lung cancer using electronic health records., Materials and Methods: We used the beta release of the All of Us Researcher Workbench with clinical and survey data from a population of 225 000 subjects. We identified 3 cohorts of individuals at high risk to develop lung cancer based on (1) the 2013 U.S. Preventive Services Task Force criteria, (2) the long-term quitters of cigarette smoking criteria, and (3) the younger age of onset criteria. We applied the logistic regression analysis to identify the significant associations between individuals' phenotypes and their risk categories. We validated our findings against a lung cancer cohort from the same population and conducted an expert review to understand whether these associations are known or potentially novel., Results: We found a total of 214 statistically significant associations (P < .05 with a Bonferroni correction and odds ratio > 1.5) enriched in the high-risk individuals from 3 cohorts, and 15 enriched in the low-risk individuals. Forty significant associations enriched in the high-risk individuals and 13 enriched in the low-risk individuals were validated in the cancer cohort. Expert review identified 15 potentially new associations enriched in the high-risk individuals., Conclusions: It is feasible to conduct a phenome-wide association study to characterize phenotypic abnormalities associated in high-risk individuals developing lung cancer using electronic health records. The All of Us Research Workbench is a promising resource for the research studies to evaluate and optimize lung cancer screening criteria., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2021
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163. Utility of Transbronchial Biopsy in the Immunocompromised Host With New Pulmonary Radiographic Abnormalities.
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Bourne MH Jr, Norton MS, Midthun DE, Mullon JJ, Kern RM, Utz JP, Nelson DR, and Edell ES
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- Bronchoalveolar Lavage methods, Humans, Lung diagnostic imaging, Lung Neoplasms diagnosis, Retrospective Studies, Biopsy methods, Bronchoscopy methods, Immunocompromised Host, Lung pathology, Lung Neoplasms pathology
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Objective: To assess how often transbronchial biopsy (TBBx) added unique positive findings apart from other synchronous bronchoscopic sampling techniques including the bronchoalveolar lavage-immunocompromised host (BAL-ICH) panel that justified changes in management in an array of immunocompromised patients with new pulmonary radiographic abnormalities., Methods: We retrospectively reviewed all bronchoscopies performed at Mayo Clinic Rochester between January 2012 and December 2017; on the basis of the physician's selection of a BAL-ICH panel, we identified 192 immunocompromised patients who underwent bronchoscopy with both a BAL-ICH panel and TBBx. The results of the BAL-ICH panel and TBBx were compared and subsequent management decisions analyzed from clinical notes. We identified changes in immunosuppressive agents, antibiotics, chemotherapy, goals of care, and decisions on further evaluation and procedures. We assessed whether the TBBx findings added information not identified on the BAL-ICH panel and other bronchoscopic sampling methods performed during the same procedure that justified subsequent management changes., Results: Of 192 bronchoscopic procedures performed on immunocompromised patients with acute and subacute pulmonary radiographic abnormalities, management changes justified by the unique positive results of the TBBx occurred 28% (51/192) of the time. Those immunocompromised by solid malignant neoplasms and receiving active immunosuppressive therapy had management changes justified 62.1% (18/29) of the time by the TBBx results. No additional fungal organisms were identified on TBBx that were accounted for on the BAL-ICH panel., Conclusion: Transbronchial biopsy may add information to other bronchoscopic findings in immunocompromised patients, especially those with solid malignant neoplasms receiving active immunosuppressive treatment. These potential benefits must be weighed against the risks inherent to the procedure., (Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
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- 2021
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164. Bronchoscopic Cryobiopsy and Forceps Biopsy for the Diagnostic Evaluation of Diffuse Parenchymal Lung Disease in Clinical Practice.
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Koslow M, Edell ES, Midthun DE, Mullon JJ, Kern RM, Nelson DR, Sakata KK, Moua T, Roden AC, Yi ES, Reisenauer JS, Decker PA, and Ryu JH
- Abstract
Objective: To assess the contribution and safety of bronchoscopic cryobiopsy vs traditional forceps biopsy used in clinical practice for diagnosing diffuse parenchymal lung disease (DPLD)., Patients and Methods: We identified 271 patients who underwent bronchoscopic biopsy for DPLD at Mayo Clinic, MN (June 1, 2013, through September 30, 2017). Medical records were reviewed including prebiopsy clinical and radiographic impressions. Diagnostic yield was assessed in terms of a specific histologic pattern resulting in a diagnosis when combined with the clinical-radiologic context. Clinical utility was defined as a biopsy result deemed useful in patient management., Results: The cohort included 120 cryobiopsy and 151 forceps biopsy cases with mean age 61±14 years and 143 (53%) men. Diagnostic yield (55% vs 41%; odds ratio [OR], 1.73; 95% CI, 1.07 to 2.83; P =.026) and clinical utility (60% vs 40%; OR, 2.21; 95% CI, 1.36 to 3.63; P =.001) were higher for the cryobiopsy group, and the association remained after control for prebiopsy clinical impressions (OR, 2.21; 95% CI, 1.22 to 4.08; P =.010 and OR, 3.23; 95% CI, 1.76 to 6.10; P <.001, respectively). However, pneumothorax (5.4% vs 0.7%; P =.022) and serious bleeding (7.1% vs 0%; P =.001) rates were higher for the cryobiopsy group. Thirty-day mortality was 1.6% in the cryobiopsy group vs 0% for the forceps biopsy group ( P =.20)., Conclusion: Bronchoscopic cryobiopsy revealed higher diagnostic yield and clinical utility than did forceps biopsy. However, procedure-related complications were higher in the cryobiopsy group. The choice of bronchoscopic biopsy procedure for patients with DPLD depends on the clinicalradiologic context., (© 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc.)
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- 2020
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165. Diagnostic Yield and Bleeding Complications Associated With Bronchoscopic Biopsy of Endobronchial Carcinoid Tumors.
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Gao Y, Moua T, Midthun DE, Mullon JJ, Decker PA, and Ryu JH
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- Adult, Aged, Bronchoscopy methods, Bronchoscopy statistics & numerical data, Carcinoid Tumor blood supply, Carcinoid Tumor diagnosis, Case-Control Studies, Female, Hemoptysis diagnosis, Hemoptysis epidemiology, Hemorrhage epidemiology, Humans, Male, Middle Aged, Retrospective Studies, Biopsy adverse effects, Bronchial Neoplasms pathology, Carcinoid Tumor pathology, Hemorrhage etiology
- Abstract
Background: Bronchial carcinoid often appears hypervascular on bronchoscopic visualization and may be associated with hemoptysis. The diagnostic yield and bleeding complications associated with bronchoscopic biopsy of bronchial carcinoid tumors remain unclear., Materials and Methods: Patients with bronchial carcinoid tumors that were bronchoscopically visualized and biopsied at our tertiary referral medical center, over an 8-year period from 2010 to 2017, were retrospectively identified and reviewed to assess diagnostic yield and bleeding complications. Correlations with patient characteristics and carcinoid tumor features were analyzed., Results: Forty-nine patients were included (57% female). Tumors were predominantly (71%) located in proximal airways (mainstem and lobar bronchi). Bronchoscopic biopsy was diagnostic in 45 patients (92%). Thirteen patients (27%) experienced moderate (n=12, 25%) or severe (n=1, 2%) bleeding. Among these, 6 tumors (46%) had a vascular appearance and 4 patients (31%) had experienced recent hemoptysis. However, neither vascularity nor hemoptysis was associated with bleeding at biopsy (P=0.68 and 0.73, respectively). Carcinoid tumors were classified as typical in 79% and atypical in 21% with no difference in diagnostic yield or bleeding risk (P=0.28 and 0.92, respectively). Tumor size was also not associated with increased diagnostic yield or bleeding risk (P=0.54 and 0.39, respectively)., Conclusion: Bronchoscopic biopsy of endobronchial carcinoid is associated with a high diagnostic yield and severe bleeding is rarely encountered. Diagnostic yield and bleeding seemed independent of vascular tumor appearance or history of recent hemoptysis.
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- 2020
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166. Dysphonia Due to Vocal Cord Injury After Rigid Bronchoscopy: A Case Study With 1-Year Bronchoscopic Follow-up.
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Youssef SJ, Orbelo DM, Sakata KK, Zimmermann TM, Pittelko RL, Nelson DR, Midthun DE, Edell ES, and Ekbom DC
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- Bronchial Diseases, Diagnosis, Differential, Dysphonia etiology, Female, Humans, Iatrogenic Disease, Middle Aged, Postoperative Complications diagnosis, Postoperative Complications etiology, Stents, Bronchoscopy adverse effects, Dysphonia diagnosis, Vocal Cords injuries
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- 2019
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167. RNAseq analysis of bronchial epithelial cells to identify COPD-associated genes and SNPs.
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Yeo J, Morales DA, Chen T, Crawford EL, Zhang X, Blomquist TM, Levin AM, Massion PP, Arenberg DA, Midthun DE, Mazzone PJ, Nathan SD, Wainz RJ, Nana-Sinkam P, Willey PFS, Arend TJ, Padda K, Qiu S, Federov A, Hernandez DR, Hammersley JR, Yoon Y, Safi F, Khuder SA, and Willey JC
- Subjects
- Alleles, Case-Control Studies, Female, Gene Expression Regulation, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Pulmonary Disease, Chronic Obstructive pathology, Quantitative Trait Loci, Sequence Analysis, RNA, Bronchi pathology, DNA-Binding Proteins genetics, Endonucleases genetics, Epithelial Cells metabolism, Nuclear Proteins genetics, Pulmonary Disease, Chronic Obstructive genetics, Transcription Factors genetics
- Abstract
Background: There is a need for more powerful methods to identify low-effect SNPs that contribute to hereditary COPD pathogenesis. We hypothesized that SNPs contributing to COPD risk through cis-regulatory effects are enriched in genes comprised by bronchial epithelial cell (BEC) expression patterns associated with COPD., Methods: To test this hypothesis, normal BEC specimens were obtained by bronchoscopy from 60 subjects: 30 subjects with COPD defined by spirometry (FEV1/FVC < 0.7, FEV1% < 80%), and 30 non-COPD controls. Targeted next generation sequencing was used to measure total and allele-specific expression of 35 genes in genome maintenance (GM) genes pathways linked to COPD pathogenesis, including seven TP53 and CEBP transcription factor family members. Shrinkage linear discriminant analysis (SLDA) was used to identify COPD-classification models. COPD GWAS were queried for putative cis-regulatory SNPs in the targeted genes., Results: On a network basis, TP53 and CEBP transcription factor pathway gene pair network connections, including key DNA repair gene ERCC5, were significantly different in COPD subjects (e.g., Wilcoxon rank sum test for closeness, p-value = 5.0E-11). ERCC5 SNP rs4150275 association with chronic bronchitis was identified in a set of Lung Health Study (LHS) COPD GWAS SNPs restricted to those in putative regulatory regions within the targeted genes, and this association was validated in the COPDgene non-hispanic white (NHW) GWAS. ERCC5 SNP rs4150275 is linked (D' = 1) to ERCC5 SNP rs17655 which displayed differential allelic expression (DAE) in BEC and is an expression quantitative trait locus (eQTL) in lung tissue (p = 3.2E-7). SNPs in linkage (D' = 1) with rs17655 were predicted to alter miRNA binding (rs873601). A classifier model that comprised gene features CAT, CEBPG, GPX1, KEAP1, TP73, and XPA had pooled 10-fold cross-validation receiver operator characteristic area under the curve of 75.4% (95% CI: 66.3%-89.3%). The prevalence of DAE was higher than expected (p = 0.0023) in the classifier genes., Conclusions: GM genes comprised by COPD-associated BEC expression patterns were enriched for SNPs with cis-regulatory function, including a putative cis-rSNP in ERCC5 that was associated with COPD risk. These findings support additional total and allele-specific expression analysis of gene pathways with high prior likelihood for involvement in COPD pathogenesis.
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- 2018
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168. The flip-flop fungus sign: an FDG PET/CT sign of benignity.
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Nagelschneider AA, Broski SM, Holland WP, Midthun DE, Sykes AM, Lowe VJ, Peller PJ, and Johnson GB
- Abstract
Benign granulomatous processes such as fungal infection may mimic metastatic lung cancer on FDG PET/CT. We found that these processes often have draining lymph node(s) with equal or greater FDG activity than associated lung nodule(s), a "flip-flop" of what is commonly seen in lung cancer. The aim of this study was to examine the utility of this "flip-flop fungus" (FFF) sign for diagnosing benign pulmonary disease. FDG PET/CT scans performed between 9/09-3/13 for the indications of pulmonary nodule or mass were reviewed. Scans with at least one hilar or mediastinal FDG avid draining node were included. Patients with a history of cancer, lack of pathologic confirmation, or without at least two years of imaging follow-up were excluded. A total of 209 FDG PET/CT exams were included and reviewed in a blinded fashion. A positive FFF sign had a sensitivity of 60.0% (95% CI: 47.6-71.5%) and specificity of 84.9% (95% CI: 77.8-90.4%) (P<0.0001) for benign disease. With additional strict imaging criteria applied, the FFF sign had a specificity of 98.6% (95% CI: 94.9-99.8%) (P<0.0001) and a positive predictive value of 90.0% (95% CI: 68.3-98.5%). A positive FFF sign was predominately due to granulomatous disease (91%), mostly histoplasmosis (73%). A positive FFF sign combined with positive fungal serology (n=16) had a specificity of 100% for benign disease. The FFF sign predicts benign disease in patients with a lung nodule(s) and an FDG avid draining lymph node(s) that would otherwise be considered worrisome for cancer., Competing Interests: None.
- Published
- 2017
169. Quality of Shared Decision Making in Lung Cancer Screening: The Right Process, With the Right Partners, at the Right Time and Place.
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Dobler CC, Midthun DE, and Montori VM
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- Humans, Quality of Health Care, Referral and Consultation, Time Factors, Decision Making, Early Detection of Cancer methods, Lung Neoplasms diagnosis
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- 2017
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170. Inaccuracies Describing Results of a Lung Cancer Screening Demonstration Project.
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Humphrey LL, Deffebach M, and Midthun DE
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- Humans, Incidental Findings, Mass Screening, Early Detection of Cancer, Lung Neoplasms
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- 2017
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171. Management of Multifocal Lung Cancer: Results of a Survey.
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Leventakos K, Peikert T, Midthun DE, Molina JR, Blackmon S, Nichols FC, Garces YI, Hallemeier CL, Murphy SJ, Vasmatzis G, Kratz SL, Holland WP, Thomas CF, Mullon JJ, Shen KR, Cassivi SD, Marks RS, Aubry MC, Adjei AA, Yang P, Allen MS, Edell ES, Wigle D, and Mansfield AS
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- Humans, Male, Middle Aged, Neoplasm Staging, Surveys and Questionnaires, Lung Neoplasms therapy
- Abstract
Introduction: Multifocal lung cancer is an increasingly common clinical scenario, but there is lack of high-level evidence for its optimal treatment. Thus, we surveyed members of the interdisciplinary International Association for the Study of Lung Cancer on their therapeutic approaches and analyzed the resultant practice patterns., Methods: We described the clinical scenario of an otherwise healthy 60-year-old man with bilateral pulmonary nodules and asked the 6373 members of the International Association for the Study of Lung Cancer whether they would recommend surgery, and if so, the extent of surgery. We also asked what other measures would be recommended to complete the staging and whether radiation therapy or chemotherapy would be suggested., Results: We received 221 responses (response rate 3.5%) from multiple specialists. Most respondents (140 [63%]) recommended surgery for this scenario. Surgeons were significantly more likely to recommend surgery than were those in other specialties. Of those who recommended surgery, most would obtain a PET/CT scan to rule out distant metastases and a magnetic resonance imaging scan to rule out brain metastases; but in the absence of radiographic lymph node involvement, most would not stage the mediastinum by bronchoscopy or mediastinoscopy before resection. When surgery was not recommended or declined, respondents commonly recommended radiation., Conclusions: This survey suggests that therapeutic recommendations for multifocal lung cancer are influenced to a large extent by physicians' specialty training, probably because of the lack of high-level evidence for its standard treatment. Ongoing systematic and multidisciplinary approaches with robust short-term and long-term patient outcomes may improve the quality of evidence for the optimal management of this clinical entity., (Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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172. Trends in Subpopulations at High Risk for Lung Cancer.
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Yang P, Wang Y, Wampfler JA, Xie D, Stoddard SM, She J, and Midthun DE
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- Advisory Committees, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Lung Neoplasms etiology, Male, Middle Aged, Prospective Studies, Smoking adverse effects, Early Detection of Cancer, Lung Neoplasms diagnosis
- Abstract
Introduction: Two-thirds of patients in the United States with newly diagnosed lung cancer would not meet the current U.S. Preventive Services Task Force (USPSTF) screening criteria, which suggests a need for amendment of the definition of high risk. To provide evidence of additional high-risk subpopulations and estimated gains and losses from using different criteria for screening eligibility, we conducted a two-step study using three cohorts., Methods: The two prospective cohorts comprised 5988 patients in whom primary lung cancer was diagnosed between 1997 and 2011 (the hospital cohort) and 850 defined-community residents (the community cohort); the retrospective cohort consisted of the population of Olmsted County, Minnesota, which was observed for 28 years (1984-2011). Subgroups of patients with lung cancer who might have been identified using additional determinates were estimated and compared between the community and hospital cohorts. The findings were supported by indirect comparative projections of two ratios: benefit to harm and cost to effectiveness., Results: Former cigarette smokers who had a smoking history of 30 or more pack-years and 15 to 30 quit-years and were 55 to 80 years old formed the largest subgroup not meeting the current screening criteria; they constituted 12% of the hospital cohort and 17% of community cohort. Using the expanded criteria suggested by our study may add 19% more CT examinations for detecting 16% more cases when compared with the USPSTF criteria. Meanwhile, the increases in false-positive results, overdiagnosis, and radiation-related lung cancer deaths are 0.6%, 0.1%, and 4.0%, respectively., Conclusions: Current USPSTF screening criteria exclude many patients who are at high risk for development of lung cancer. Including individuals who are younger than 81 years, have a smoking history of 30 or more pack-years, and have quit for 15 to 30 years may significantly increase the number of cases of non-overdiagnosed screen-detected lung cancer, does not significantly add to the number of false-positive cases, and saves more lives with an acceptable amount of elevated exposure to radiation and cost., (Copyright © 2015 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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173. Acute Bilateral Pulmonary Opacities Associated With Use of Tocilizumab.
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Utz JP, Jinnur PK, Yi ES, Ryu JH, Midthun DE, and Davis JM 3rd
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- Acute Lung Injury diagnosis, Acute Lung Injury therapy, Humans, Male, Middle Aged, Acute Lung Injury chemically induced, Antibodies, Monoclonal, Humanized adverse effects, Cogan Syndrome drug therapy
- Published
- 2015
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174. An official American Thoracic Society/American College of Chest Physicians policy statement: implementation of low-dose computed tomography lung cancer screening programs in clinical practice.
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Wiener RS, Gould MK, Arenberg DA, Au DH, Fennig K, Lamb CR, Mazzone PJ, Midthun DE, Napoli M, Ost DE, Powell CA, Rivera MP, Slatore CG, Tanner NT, Vachani A, Wisnivesky JP, and Yoon SH
- Subjects
- Humans, Mass Screening economics, Radiation Dosage, Radiography, Thoracic standards, Smoking Cessation, Societies, Medical, Solitary Pulmonary Nodule diagnostic imaging, Tomography, X-Ray Computed, United States, Lung Neoplasms diagnostic imaging, Mass Screening standards
- Abstract
Rationale: Annual low-radiation-dose computed tomography (LDCT) screening for lung cancer has been shown to reduce lung cancer mortality among high-risk individuals and is now recommended by multiple organizations. However, LDCT screening is complex, and implementation requires careful planning to ensure benefits outweigh harms. Little guidance has been provided for sites wishing to develop and implement lung cancer screening programs., Objectives: To promote successful implementation of comprehensive LDCT screening programs that are safe, effective, and sustainable., Methods: The American Thoracic Society (ATS) and American College of Chest Physicians (ACCP) convened a committee with expertise in lung cancer screening, pulmonary nodule evaluation, and implementation science. The committee reviewed the evidence from systematic reviews, clinical practice guidelines, surveys, and the experience of early-adopting LDCT screening programs and summarized potential strategies to implement LDCT screening programs successfully., Measurements and Main Results: We address steps that sites should consider during the main three phases of developing an LDCT screening program: planning, implementation, and maintenance. We present multiple strategies to implement the nine core elements of comprehensive lung cancer screening programs enumerated in a recent ACCP/ATS statement, which will allow sites to select the strategy that best fits with their local context and workflow patterns. Although we do not comment on cost-effectiveness of LDCT screening, we outline the necessary costs associated with starting and sustaining a high-quality LDCT screening program., Conclusions: Following the strategies delineated in this policy statement may help sites to develop comprehensive LDCT screening programs that are safe and effective.
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- 2015
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175. Spontaneous Regression of Malignant Pleural Mesothelioma in a Patient with New-Onset Inflammatory Arthropathy.
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Moser JC, Peikert T, Roden AC, Midthun DE, and Mansfield AS
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- Aged, Biopsy, Female, Humans, Mesothelioma, Malignant, Tomography, X-Ray Computed, Lung Neoplasms diagnosis, Lung Neoplasms pathology, Mesothelioma diagnosis, Mesothelioma pathology, Neoplasm Regression, Spontaneous, Pleural Neoplasms diagnosis
- Published
- 2015
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176. An Official American Thoracic Society Research Statement: A Research Framework for Pulmonary Nodule Evaluation and Management.
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Slatore CG, Horeweg N, Jett JR, Midthun DE, Powell CA, Wiener RS, Wisnivesky JP, and Gould MK
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- Consensus, Early Detection of Cancer, Humans, Patient Outcome Assessment, Societies, Medical, United States, Lung Neoplasms diagnosis, Lung Neoplasms therapy
- Abstract
Background: Pulmonary nodules are frequently detected during diagnostic chest imaging and as a result of lung cancer screening. Current guidelines for their evaluation are largely based on low-quality evidence, and patients and clinicians could benefit from more research in this area., Methods: In this research statement from the American Thoracic Society, a multidisciplinary group of clinicians, researchers, and patient advocates reviewed available evidence for pulmonary nodule evaluation, characterized six focus areas to direct future research efforts, and identified fundamental gaps in knowledge and strategies to address them. We did not use formal mechanisms to prioritize one research area over another or to achieve consensus., Results: There was widespread agreement that novel tests (including novel imaging tests and biopsy techniques, biomarkers, and prognostic models) may improve diagnostic accuracy for identifying cancerous nodules. Before they are used in clinical practice, however, better evidence is needed to show that they improve more distal outcomes of importance to patients. In addition, the pace of research and the quality of clinical care would be improved by the development of registries that link demographic and nodule characteristics with patient-level outcomes. Methods to share data from registries are also necessary., Conclusions: This statement may help researchers to develop impactful and innovative research projects and enable funders to better judge research proposals. We hope that it will accelerate the pace and increase the efficiency of discovery to improve the quality of care for patients with pulmonary nodules.
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- 2015
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177. Validation of a multiprotein plasma classifier to identify benign lung nodules.
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Vachani A, Pass HI, Rom WN, Midthun DE, Edell ES, Laviolette M, Li XJ, Fong PY, Hunsucker SW, Hayward C, Mazzone PJ, Madtes DK, Miller YE, Walker MG, Shi J, Kearney P, Fang KC, and Massion PP
- Subjects
- Aged, Female, Humans, Lung Neoplasms classification, Lung Neoplasms diagnosis, Male, Middle Aged, Multiple Pulmonary Nodules classification, Multiple Pulmonary Nodules diagnosis, ROC Curve, Retrospective Studies, Algorithms, Biomarkers, Tumor blood, Lung Neoplasms blood, Multiple Pulmonary Nodules blood, Proteomics methods
- Abstract
Introduction: Indeterminate pulmonary nodules (IPNs) lack clinical or radiographic features of benign etiologies and often undergo invasive procedures unnecessarily, suggesting potential roles for diagnostic adjuncts using molecular biomarkers. The primary objective was to validate a multivariate classifier that identifies likely benign lung nodules by assaying plasma protein expression levels, yielding a range of probability estimates based on high negative predictive values (NPVs) for patients with 8 to 30 mm IPNs., Methods: A retrospective, multicenter, case-control study was performed using multiple reaction monitoring mass spectrometry, a classifier comprising five diagnostic and six normalization proteins, and blinded analysis of an independent validation set of plasma samples., Results: The classifier achieved validation on 141 lung nodule-associated plasma samples based on predefined statistical goals to optimize sensitivity. Using a population based nonsmall-cell lung cancer prevalence estimate of 23% for 8 to 30 mm IPNs, the classifier identified likely benign lung nodules with 90% negative predictive value and 26% positive predictive value, as shown in our prior work, at 92% sensitivity and 20% specificity, with the lower bound of the classifier's performance at 70% sensitivity and 48% specificity. Classifier scores for the overall cohort were statistically independent of patient age, tobacco use, nodule size, and chronic obstructive pulmonary disease diagnosis. The classifier also demonstrated incremental diagnostic performance in combination with a four-parameter clinical model., Conclusions: This proteomic classifier provides a range of probability estimates for the likelihood of a benign etiology that may serve as a noninvasive, diagnostic adjunct for clinical assessments of patients with IPNs.
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- 2015
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178. Trends in the proportion of patients with lung cancer meeting screening criteria.
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Wang Y, Midthun DE, Wampfler JA, Deng B, Stoddard SM, Zhang S, and Yang P
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- Adult, Age of Onset, Aged, Aged, 80 and over, Early Detection of Cancer, Humans, Incidence, Lung Neoplasms diagnosis, Male, Middle Aged, Minnesota epidemiology, Smoking epidemiology, Lung Neoplasms epidemiology
- Published
- 2015
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179. Vanishing lung syndrome (idiopathic giant bullous emphysema).
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Liang JJ, Wigle DA, and Midthun DE
- Subjects
- Adult, Blister surgery, Humans, Male, Pulmonary Emphysema surgery, Syndrome, Blister diagnosis, Pulmonary Emphysema diagnosis
- Published
- 2014
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180. Screening for lung cancer: the US studies.
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Midthun DE and Jett JR
- Subjects
- Humans, Randomized Controlled Trials as Topic, Tomography, X-Ray Computed, United States, Early Detection of Cancer, Lung Neoplasms diagnosis
- Abstract
Efforts in lung cancer screening with chest X-ray (CXR) and sputum cytology in the 1970s and 1980s were negative. In the ensuing decade, the early lung cancer action project (ELCAP), and the Mayo screening study showed the promise of low-dose CT. These and other studies led to the National lung screening study (NLST), which showed definitively that low-dose spiral computed tomography had a measurable impact on mortality and could be justified as a tool for lung cancer screening. This review examines the results of past and recent studies of lung cancer screening., (© 2013 Wiley Periodicals, Inc.)
- Published
- 2013
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181. Favorable stage distribution in the NELSON trial: promise or hype?
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Midthun DE and Gould MK
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- Female, Humans, Male, Adenocarcinoma diagnosis, Early Detection of Cancer methods, Lung Neoplasms diagnosis, Smoking adverse effects
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- 2013
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182. Lung cancer screening experience: a retrospective review of PET in 22 non-small cell lung carcinomas detected on screening chest CT in a high-risk population.
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Lindell RM, Hartman TE, Swensen SJ, Jett JR, Midthun DE, Nathan MA, and Lowe VJ
- Subjects
- Carcinoma, Non-Small-Cell Lung epidemiology, Female, Humans, Incidence, Lung Neoplasms epidemiology, Male, Prevalence, Retrospective Studies, Solitary Pulmonary Nodule diagnostic imaging, Solitary Pulmonary Nodule epidemiology, Carcinoma, Non-Small-Cell Lung diagnostic imaging, Lung Neoplasms diagnostic imaging, Mass Screening methods, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
Objective: The objective of our study was to retrospectively review the PET results of non-small cell lung carcinomas detected on screening chest CT in a high-risk population., Conclusion: PET findings were negative in 32% of the cases of non-small cell carcinomas that were detected on screening CT in a high-risk patient population. These tumors were small, low-grade, or both. The most common histology was bronchioloalveolar cell carcinoma. The role of PET in evaluating screening-detected indeterminate nodules in a high-risk population may be more limited than in a general population.
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- 2005
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183. Clinical problem-solving. Occam's razor versus Saint's Triad.
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Hilliard AA, Weinberger SE, Tierney LM Jr, Midthun DE, and Saint S
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- Anticoagulants therapeutic use, Arthritis complications, Arthritis drug therapy, Blood Cell Count, Bronchoscopy, CREST Syndrome complications, Cough etiology, Diagnosis, Differential, Female, Heparin therapeutic use, Humans, Lung diagnostic imaging, Middle Aged, Pain etiology, Pneumonia, Pneumocystis complications, Pneumonia, Pneumocystis drug therapy, Pulmonary Embolism complications, Pulmonary Embolism drug therapy, Tomography, Spiral Computed, Dyspnea etiology, Pneumonia, Pneumocystis diagnosis, Pulmonary Embolism diagnostic imaging
- Published
- 2004
- Full Text
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