Publications by authors named "Jeroen Veltman"

Article Synopsis
  • Biparametric MRI (bpMRI) may serve as a valid alternative to multiparametric MRI (mpMRI) for diagnosing clinically significant prostate cancer (csPCa), as assessed in a large international observer study.
  • The study involved 400 mpMRI examinations from four different European centers, where readers evaluated both bpMRI and mpMRI for their ability to accurately diagnose csPCa, finding them to be similarly effective.
  • Key findings indicated that bpMRI and mpMRI had comparable diagnostic accuracy (AUROC values) and sensitivity, with bpMRI showing a noninferior performance, though both methods had similar specificity when distinguishing csPCa.
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Background: Artificial intelligence (AI) systems can potentially aid the diagnostic pathway of prostate cancer by alleviating the increasing workload, preventing overdiagnosis, and reducing the dependence on experienced radiologists. We aimed to investigate the performance of AI systems at detecting clinically significant prostate cancer on MRI in comparison with radiologists using the Prostate Imaging-Reporting and Data System version 2.1 (PI-RADS 2.

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Purpose: Follow-up guidelines barely diverge from a one-size-fits-all approach, even though the risk of recurrence differs per patient. However, the personalization of breast cancer care improves outcomes for patients. This study explores the variation in follow-up pathways in the Netherlands using real-world data to determine guideline adherence and the gap between daily practice and risk-based surveillance, to demonstrate the benefits of personalized risk-based surveillance compared with usual care.

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Background: In the Netherlands, the COVID-19 pandemic resulted in a temporary halt of population screening for cancer and limited hospital capacity for non-COVID care. We aimed to investigate the impact of the pandemic on the in-hospital diagnostic pathway of breast cancer (BC) and colorectal cancer (CRC).

Methods: 71,159 BC and 48,900 CRC patients were selected from the Netherlands Cancer Registry.

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Article Synopsis
  • The study looked at how having an MRI before surgery affects the chances of needing a mastectomy or having to have more surgery for women with ductal carcinoma in situ (DCIS), a type of breast cancer.
  • They compared two groups of patients: one that had MRIs before surgery and one that didn't, looking closely at various factors that could affect the results.
  • The results showed that women who had the MRI were more likely to have a mastectomy but were less likely to need additional surgeries afterwards.
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Patients with localized recurrent prostate cancer (PCa) are eligible for androgen-deprivation therapy, salvage radical prostatectomy (RP) or radiation therapy. These treatments are associated with serious side-effects, illustrating the need for alternative local treatment options with lower morbidity rates. All patients who underwent magnetic resonance imaging (MRI)-guided salvage focal cryoablation (SFC) with localized recurrent PCa between 2011-2021 ( = 114) were included.

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Objectives: To report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes.

Methods: The MIPA observational study enrolled women aged 18-80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis.

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Accurately determining the molecular subtypes of breast cancer is important for the prognosis of breast cancer patients and can guide treatment selection. In this study, we develop a deep learning-based model for predicting the molecular subtypes of breast cancer directly from the diagnostic mammography and ultrasound images. Multi-modal deep learning with intra- and inter-modality attention modules (MDL-IIA) is proposed to extract important relations between mammography and ultrasound for this task.

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Background: Regular follow-up after treatment for breast cancer is crucial to detect potential recurrences and second contralateral breast cancer in an early stage. However, information about follow-up patterns in the Netherlands is scarce.

Patients And Methods: Details concerning diagnostic procedures and policlinic visits in the first 5 years following a breast cancer diagnosis were gathered between 2009 and 2019 for 9916 patients from 4 large Dutch hospitals.

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Objectives: This study aimed to systematically review recent health economic evaluations (HEEs) of artificial intelligence (AI) applications in healthcare. The aim was to discuss pertinent methods, reporting quality and challenges for future implementation of AI in healthcare, and additionally advise future HEEs.

Methods: A systematic literature review was conducted in 2 databases (PubMed and Scopus) for articles published in the last 5 years.

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The goal of this study was to describe the variation in hospital-based diagnostic care activities for patients with symptomatology suspect for breast cancer in The Netherlands. Two cohorts were included: the 'benign' cohort (30,334 women suspected of, but without breast cancer) and the 'malignant' cohort (2236 breast cancer patients). Hospital-based financial data was combined with tumor data (malignant cohort) from The Netherlands Cancer Registry.

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Objectives: Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue.

Methods: This observational study enrolled women aged 18-80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers.

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Purpose: We analysed incidence, treatment, survival, occurrence of ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC) after lobular carcinoma in situ (LCIS) in the Netherlands.

Methods: All women diagnosed with classic LCIS between 1989 and 2017 were identified from the Netherlands Cancer Registry. We calculated overall (OS), relative survival (RS) and cumulative incidence functions (CIF, accounting for competing risks) of mortality, DCIS and IBC.

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Background High breast density increases breast cancer risk and lowers mammographic sensitivity. Supplemental MRI screening improves cancer detection but increases the number of false-positive screenings. Thus, methods to distinguish true-positive MRI screening results from false-positive ones are needed.

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Article Synopsis
  • This study looked at ways to tell if men might have serious prostate cancer without doing too many tests, which can be uncomfortable and not always necessary.
  • Researchers tested a method called SelectMDx along with another test, mpMRI, to see how they worked together to help figure out who really needed a biopsy.
  • They found that using SelectMDx helped avoid a lot of unnecessary biopsies, but sometimes it missed detecting some high-grade cancers, so they are still figuring out the best way to use these tests together.
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Background In the first (prevalent) supplemental MRI screening round of the Dense Tissue and Early Breast Neoplasm Screening (DENSE) trial, a considerable number of breast cancers were found at the cost of an increased false-positive rate (FPR). In incident screening rounds, a lower cancer detection rate (CDR) is expected due to a smaller pool of prevalent cancers, and a reduced FPR, due to the availability of prior MRI examinations. Purpose To investigate screening performance indicators of the second round (incidence round) of the DENSE trial.

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Article Synopsis
  • The study aimed to evaluate the effectiveness of chest CT and RT-PCR tests for COVID-19 in asymptomatic surgical patients.
  • The research involved 2,093 patients across 14 centers, revealing a low positive yield of COVID-19 cases—1.5% for combined testing, 0.7% for CT, and 1.1% for RT-PCR.
  • Results indicated that while preoperative screening helped ensure safety in surgeries, the value of chest CT testing was minimal compared to RT-PCR, particularly as community COVID-19 prevalence increased.
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Objectives: An important aim of follow-up after primary breast cancer treatment is early detection of locoregional recurrences (LRR). This study compares 2 personalized follow-up scheme simulations based on LRR risk predictions provided by a time-dependent prognostic model for breast cancer LRR and quantifies their possible follow-up efficiency.

Methods: Surgically treated early patients with breast cancer between 2003 and 2008 were selected from the Netherlands Cancer Registry.

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Objectives: This study aims to define consensus-based criteria for acquiring and reporting prostate MRI and establishing prerequisites for image quality.

Methods: A total of 44 leading urologists and urogenital radiologists who are experts in prostate cancer imaging from the European Society of Urogenital Radiology (ESUR) and EAU Section of Urologic Imaging (ESUI) participated in a Delphi consensus process. Panellists completed two rounds of questionnaires with 55 items under three headings: image quality assessment, interpretation and reporting, and radiologists' experience plus training centres.

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Despite its high diagnostic performance, the use of breast MRI in the preoperative setting is controversial. It has the potential for personalized surgical management in breast cancer patients, but two of three randomized controlled trials did not show results in favor of its introduction for assessing the disease extent before surgery. Meta-analyses showed a higher mastectomy rate in women undergoing preoperative MRI compared to those who do not.

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Purpose: The biopsy procedure is an important phase in breast cancer diagnosis. Accurate breast imaging and precise needle placement are crucial in lesion targeting. This paper presents an end-effector (EE) for robotic 3D ultrasound (US) breast acquisitions and US-guided breast biopsies.

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Article Synopsis
  • A study in the Netherlands involved over 40,000 women aged 50-75 with extremely dense breast tissue, comparing those who received supplemental MRI screenings to those who had only mammograms.
  • MRI screenings significantly reduced the rate of interval breast cancers, showing a 2.5 per 1000 screenings improvement in early detection compared to mammography alone.
  • Although 59% of participants accepted the invitation for MRI, the screening process had a relatively low positive predictive value, with a small percentage experiencing adverse events.
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Article Synopsis
  • The study aims to evaluate the effectiveness of quicker, simpler MRI techniques (monoplanar "fast" bp-MRI and triplanar bp-MRI) compared to standard contrast-enhanced mp-MRI for diagnosing high-grade prostate cancer (PCa) in men who have not yet had a biopsy.
  • A total of 626 biopsy-naïve men participated, with their MRIs assessed by expert readers before undergoing systematic biopsies.
  • Results showed that all MRI protocols had a high sensitivity (95%) for detecting high-grade PCa, with "fast" bp-MRI being significantly quicker and capable of avoiding unnecessary biopsies for a large percentage of men.
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Aim: This study was conducted in order to investigate the role of gray-scale ultrasound (US) and optoacoustic imaging combined with gray-scale ultrasound (OA/US) to better differentiate between breast cancer molecular subtypes.

Materials And Methods: All 67 malignant masses included in the Maestro trial were retrospectively reviewed to compare US and OA/US feature scores and histopathological findings. Kruskal-Wallis tests were used to analyze the relationship between US and OA/US features and molecular subtypes of breast cancer.

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