Diagnostic workup for postmenopausal bleeding: a randomised controlled trial.

Objective: To evaluate the effectiveness of hysteroscopy for the detection and treatment of endometrial polyps versus expectant management in women with postmenopausal bleeding (PMB), a thickened endometrium and benign endometrial sampling.

Design: Multicentre, randomised controlled trial.

Setting: Three academic hospitals and nine non-academic teaching hospitals in the Netherlands.

Image Quality of a Novel Frequency Selective Nonlinear Blending Algorithm: An Ex Vivo Phantom Study in Comparison to Single-Energy Acquisitions and Dual-Energy Acquisitions With Monoenergetic Reconstructions.

Objective: Aim of this ex vivo phantom study was to evaluate the contrast enhancement applying a new frequency split nonlinear blending algorithm (best contrast [BC]) and to compare it with standard 120-kV single-energy computed tomography (SECT) images, as well as with low-kiloelectron volt monoenergetic extrapolations (Mono+40-100keV) from dual-energy CT (DECT) and with low-kilovolt (70-100 kV) SECT acquisitions.

Materials And Methods: A dilution series of iodinated contrast material-filled syringes was centered in an attenuation phantom and was scanned with SECT70-120kV and DECT80-100/Sn150. Monoenergetic images (40-100 keV) were reconstructed, and a new manual frequency split nonlinear blending algorithm (BC) was applied to SECT70kV and SECT120kV images.

Impact of iterative metal artifact reduction on diagnostic image quality in patients with dental hardware.

Background Metal artifacts often impair diagnostic accuracy in computed tomography (CT) imaging. Therefore, effective and workflow implemented metal artifact reduction algorithms are crucial to gain higher diagnostic image quality in patients with metallic hardware. Purpose To assess the clinical performance of a novel iterative metal artifact reduction (iMAR) algorithm for CT in patients with dental fillings.

Enhanced gray-white matter differentiation on non-enhanced CT using a frequency selective non-linear blending.

Introduction: The aim if this study is to find out if contrast between gray (GM) and white matter (WM) on non-enhanced brain CT (NECT) can be enhanced by using a frequency selective non-linear blending.

Methods: Thirty consecutive patients (40 % female; mean age 67.73 ± 12.

The FAST-EU trial: 12-month clinical outcomes of women after intrauterine sonography-guided transcervical radiofrequency ablation of uterine fibroids.

The FAST-EU Trial was designed to establish the effectiveness and confirm the safety of transcervical intrauterine sonography-guided radiofrequency ablation with the VizAblate™ System in the treatment of symptomatic uterine fibroids. This was a multicenter, prospective, single-arm trial involving academic and community hospitals in the United Kingdom, the Netherlands, and Mexico. Women with qualifying uterine fibroids and heavy menstrual bleeding underwent intrauterine sonography-guided transcervical radiofrequency ablation (RFA) with the VizAblate System; anesthesia was individualized.

Accuracy of Non-Enhanced CT in Detecting Early Ischemic Edema Using Frequency Selective Non-Linear Blending.

Purpose: Ischemic brain edema is subtle and hard to detect by computed tomography within the first hours of stroke onset. We hypothesize that non-enhanced CT (NECT) post-processing with frequency-selective non-linear blending ("best contrast"/BC) increases its accuracy in detecting edema and irreversible tissue damage (infarction).

Methods: We retrospectively analyzed the NECT scans of 76 consecutive patients with ischemic stroke (exclusively middle cerebral artery territory-MCA) before and after post-processing with BC both at baseline before reperfusion therapy and at follow-up (5.

The accuracy of endometrial sampling in women with postmenopausal bleeding: a systematic review and meta-analysis.

Postmenopausal bleeding (PMB) can be the first sign of endometrial cancer. In case of thickened endometrium, endometrial sampling is often used in these women. In this systematic review, we studied the accuracy of endometrial sampling for the diagnoses of endometrial cancer, atypical hyperplasia and endometrial disease (endometrial pathology, including benign polyps).

Diagnosis of heavy menstrual bleeding.

Heavy menstrual bleeding (HMB) is an important health problem. This paper gives an overview of the diagnosis of HMB. For each woman, a thorough history should be taken as one should ascertain whether there are underlying factors that could cause complaints of HMB.

Bipolar versus balloon endometrial ablation in the office: a randomized controlled trial.

Objective: To compare the effectiveness of bipolar radiofrequency (Novasure®) ablation and balloon endometrial ablation (Thermablate®).

Study Design: We performed a multi-center double blind, randomized controlled trial in three hospitals in The Netherlands. Women with heavy menstrual bleeding were randomly allocated to bipolar or balloon endometrial ablation, performed in the office, using a paracervical block.

Treatment Patterns and Differences in Survival of Non-Small Cell Lung Cancer Patients Between Academic and Non-Academic Hospitals in the Netherlands.

Background: The aims of this study are to analyze differences in survival between academic and non-academic hospitals and to provide insight into treatment patterns for non-small cell lung cancer (NSCLC). Results show the state of NSCLC survival and care in the Netherlands.

Methods: The Netherlands Cancer Registry provided data on NSCLC survival for all Dutch hospitals.

Systems analysis of methylerythritol-phosphate pathway flux in E. coli: insights into the role of oxidative stress and the validity of lycopene as an isoprenoid reporter metabolite.

Background: High-throughput screening methods assume that the output measured is representative of changes in metabolic flux toward the desired product and is not affected by secondary phenotypes. However, metabolic engineering can result in unintended phenotypes that may go unnoticed in initial screening. The red pigment lycopene, a carotenoid with antioxidant properties, has been used as a reporter of isoprenoid pathway flux in metabolic engineering for over a decade.

Comparison and Combination of Dual-Energy- and Iterative-Based Metal Artefact Reduction on Hip Prosthesis and Dental Implants.

Purpose: To compare and combine dual-energy based and iterative metal artefact reduction on hip prosthesis and dental implants in CT.

Material And Methods: A total of 46 patients (women:50%,mean age:63±15years) with dental implants or hip prostheses (n = 30/20) were included and examined with a second-generation Dual Source Scanner. 120kV equivalent mixed-images were derived from reconstructions of the 100/Sn140kV source images using no metal artefact reduction (NOMAR) and iterative metal artefact reduction (IMAR).

Costs of non-small cell lung cancer in the Netherlands.

Objectives: Real-world resource use and cost data on non-small cell lung cancer (NSCLC) are scarce. This data is needed to inform health-economic modelling to assess the impact of new diagnostic and/or treatment technologies. This study provides detailed insight into real-world medical resource use and costs of stage I-IV NSCLC in the Netherlands.

Clinical Impact of Additional Cytogenetic Aberrations, cKIT and RAS Mutations, and Treatment Elements in Pediatric t(8;21)-AML: Results From an International Retrospective Study by the International Berlin-Frankfurt-Münster Study Group.

Purpose: This retrospective cohort study aimed to determine the predictive relevance of clinical characteristics, additional cytogenetic aberrations, and cKIT and RAS mutations, as well as to evaluate whether specific treatment elements were associated with outcomes in pediatric t(8;21)-positive patients with acute myeloid leukemia (AML).

Patients And Methods: Karyotypes of 916 pediatric patients with t(8;21)-AML were reviewed for the presence of additional cytogenetic aberrations, and 228 samples were screened for presence of cKIT and RAS mutations. Multivariable regression models were used to assess the relevance of anthracyclines, cytarabine, and etoposide during induction and overall treatment.

The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial.

Background: A caesarean section (CS) can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche. In recent years, an association between a niche and postmenstrual spotting after a CS has been demonstrated. Hysteroscopic resection of these niches is thought to reduce spotting and menstrual pain.

Vertebral lesion distribution in multiple myeloma--assessed by reduced-dose whole-body MDCT.

Objective: To observe the distribution and potential distribution patterns of osteolytic and sclerotic vertebral involvement in a representative collective of multiple myeloma patients.

Materials And Methods: A total of 66 consecutive patients with a diagnosis of multiple myeloma at initial diagnosis or during follow-up were examined by multidetector reduced-dose computed tomography to evaluate the distribution of bone lesions along the spine with focus on size, location, and lesion character. Confirmation of diagnosis was performed by comparison to follow-up computed tomography or magnetic resonance tomography.

Hospital of diagnosis and likelihood of surgical treatment for pancreatic cancer.

Background: Surgical resection for pancreatic cancer offers the only chance of cure. Assessment of the resectability of a pancreatic tumour is therefore of great importance. The aim of the study was to investigate whether centre of diagnosis influences the likelihood of surgery and whether this affects long-term survival.

Parasitic myoma after laparoscopic morcellation: a systematic review of the literature.

Background: Laparoscopic morcellation is frequently used for tissue removal after laparoscopic hysterectomy or myomectomy and may result in parasitic myomas, due to seeding of remained tissue fragments in the abdominal cavity. However, little is known about the incidence and risk factors of this phenomenon.

Objectives: To identify the incidence and risk factors for the development of parasitic myoma after laparoscopic morcellation.

Enhanced reading time efficiency by use of automatically unfolded CT rib reformations in acute trauma.

Rationale of this study was to evaluate whether unfolded rib images enhance time efficiency in detection of rib fractures and time efficiency in patients with acute thoracic trauma. 51 subsequent patients with thoracic trauma underwent 64-slice computed tomography. 1mm thick axial slices were reformatted using a commercially available post-processing software application generating rotatable unfolded rib images.

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology.

Both Dual Energy CT (DECT) and Volume Perfusion CT (VPCT) have gained interest in recent years with several studies providing evidence of benefits for both in a variety of oncological settings. These technologies open a new spectrum of diagnostic opportunities aiming at an improved detection and characterization of suspected tumor lesions, early evaluation of therapy response and generally more accurate treatment monitoring. Here, we review and discuss current advances, beneficial aspects and potential shortcomings of both imaging modalities with regard to their clinical use in oncology.

Intradiurnal Fluctuations of Off-Resonance Saturation Effects in Healthy Human Achilles Tendons Assessed with a 3D Ultrashort Echo Time MRI Sequence at 3 Tesla.

Purpose: The purpose of this study was to evaluate whether gravitational interstitial fluid accumulation in healthy subjects has an impact on off-resonance saturation ratios (OSR) or the volume of the Achilles tendon after a prolonged time of reduced levels of physical activity.

Materials And Methods: 7 healthy volunteers were repeatedly investigated on 3 consecutive days on a 3 T whole body MR scanner using an ultrashort echo time (UTE) imaging sequence with a Gaussian off-resonance saturation pulse at a frequency offset of 2000 Hz to calculate OSR values. For accurate volumetric quantification of the Achilles tendon, a newly developed contour detection snake algorithm was applied on high-resolution isotropic T2-weighted SPACE sequence datasets.

Hysteroscopy and heavy menstrual bleeding (to cover TCRE and second-generation endometrial ablation).

Endometrial resection and ablation are an intermediate treatment for heavy menstrual bleeding (HMB). Many women do not like the continuous use of hormones, nor do they prefer a rigorous treatment as hysterectomy. The first generation of endometrial resection/ablation is now superseded by the second-generation endometrial ablation.

The impact of diagnostic criteria on the reproducibility of the hysteroscopic diagnosis of the septate uterus: a randomized controlled trial.

Study Question: Does the use of diagnostic criteria in the hysteroscopic diagnosis of a septate uterus improve inter-observer agreement?

Summary Answer: Pre-set diagnostic criteria slightly improve the inter-observer reproducibility of hysteroscopy in diagnosing a uterine septum, although agreement remains moderate.

What Is Known Already: The inter-observer agreement on the hysteroscopic diagnosis of the septate uterus has been reported to be poor.

Study Design, Size, Duration: From April 2013 until May 2014, a randomized controlled comparative inter-observer study was performed.