Sign In Subscribe Now Dialogue and debate are integral to a free society and we welcome and encourage you to share your views on the issues of the day. We ask that you be respectful of others and their points of view, refrain from personal attacks and stay on topic. To learn about our commenting policies and how our community-based moderation works, please read our Community Guidelines uses Open Icecat to source product data faster and more efficiently helping to serve its customers and optimise its processes In the world of eCommerce, providing accurate, detailed and consistent product information is essential for the success of an online store. For Lobbes one of the largest toy retailers in the Netherlands sourcing its product information more efficiently was a top priority Thanks to its collaboration with Open Icecat Lobbes can now source product data faster and more efficiently helping it better serve its customers and optimise its processes Open Icecat is a global catalogue for sharing product information providing users free access to an extensive catalogue of product data from thousands of brands These brands sponsor the product information The platform offers detailed product descriptions images and other important details that help retailers present their products on their websites including time savings and consistency in product data It also provides the ability to respond quickly to changes in the product offering The basic information that Lobbes obtains via Open Icecat includes essential product details such as marketing texts ensuring that all products on the website are always up to date This reduces the chance of errors and allows Lobbes to quickly respond to changes in its range With Icecat’s basic information Lobbes can present its products consistently which helps build customer trust and reliability It also ensures a smooth shopping experience where customers can easily find the right products based on clear and consistent product descriptions Lobbes also uses Icecat’s Enhanced Product Stories This goes a step further than traditional product information Lobbes can present visually appealing content beyond just specifications These product stories contain interactive elements such as videos and detailed explanations of the product’s benefits They also feature stories that help customers better understand how the toy might fit into their lives This comprehensive content ensures that customers are informed and excited about the product By combining product stories with basic information Lobbes creates a rich and visually attractive product presentation This approach helps customers make informed decisions and improves their shopping experience To get in touch with Icecat to learn more about Open Icecat and Enhanced Product Stories, click here IONIA — After recently losing two assistant prosecutors to other opportunities Ionia County has found its first replacement Richard "Rick" Lobbes started as an assistant prosecutor in Ionia County on Monday “My office is very pleased to have been able to hire a person like Rick,” Butler said “He is a seasoned attorney that is already comfortable in the courtroom "His life experiences will certainly assist him in his ability to appropriately handle cases Becoming an assistant prosecutor has always been a dream of Rick’s and I am happy to have been able to offer him such and we are glad to have him on board as part of our team.” Lobbes has a Bachelor’s of Science degree in criminal justice from Grand Valley State University and attended the U.S He holds a Juris Doctor degree from Valparaiso University School of Law and has received State Court Administrative Office-approved mediator training Lobbes has worked as a law enforcement specialist in the U.S Lobbes has been a solo practitioner general practice attorney handling matters in family law Lobbes worked in law enforcement while in the Air Force and always eyed a career in prosecution Lobbes had two internships with prosecutor’s offices during law school but couldn’t find prosecution work after passing the bar Family circumstances dictated Lobbes go out on his own — becoming a practitioner “He’s always had his eye out for a good fit in a prosecutor’s office and decided to apply (in Ionia County),” Butler said reading about military history and cooking “I’m grateful for the opportunity to serve Ionia County as a member of the Prosecutor’s Office and I’m looking forward to the challenge,” Lobbes said Lobbes fills one of two vacancies in the Ionia County Prosecutor’s Office after two assistant prosecutors decided to depart. Senior Assistant Prosecutor Erica Parker took a position with the Livingston County Prosecutor’s Office while David Eberle decided to join a private law firm in Grand Rapids A position for the assistant prosecutor position in Ionia County is listed on the Prosecuting Attorneys Association of Michigan website. The starting salary for the position is listed at $47,170.50 Lobbes' arrival marks the second assistant prosecutor hire in Ionia County this year. Barbara Tsaturova returned to the Ionia County Prosecutor's Office in March to replace Giacomo Mattioli who left for a position in the Ingham County Prosecutor's Office — Contact reporter Evan Sasiela at esasiela@sentinel-standard.com. Follow him on Twitter @SalsaEvan. by Rabbi Yaakov Asher Sinclair The word "Lobbes" or "Lobbus" is part of the vernacular of British Jews but few Jews in the United States have ever heard it If one can say such a thing - Yaakov Avinu was a 'bit of a lobbes Our weekly email is chockful of interesting and relevant insights into Jewish history Thank you for signing up for the aish.com free newsletter Most Significant News Event in European Radiology Dutch debate pros and cons of contrast-enhanced mammography and MRI for screening women with dense breast tissue the heated discussion over the benefits and drawbacks of contrast-enhanced mammography and MRI for screening women with dense breast tissue was big news in the Netherlands and it was the subject of a lively debate and vote in parliament The issue came to prominence when the Dutch Health Council (Gezondheidsraad) decided against implementing breast MRI screening The group suggested that contrast-enhanced mammography should be explored as a potential alternative through a new trial Then a member of the Ministry of Health subcommittee appeared to undermine the official recommendations of the Health Secretary by proposing that women with dense breast tissue undergo MRI for screening and be told about their breast density in addition to planning for the contrast-enhanced mammography trial recommended by the Health Council The Dutch Society of Radiology (NVvR) welcomed the development but some radiologists expressed mixed feelings on the long-term role of both MRI and contrast-enhanced mammography in screening "In practice, implementation of MRI screening will have some challenges," Dr. Marc Lobbes, PhD, a breast radiologist at the Zuyderland Medical Center and the Maastricht University Medical Center in the Netherlands, told AuntMinnieEurope.com The cost of screening will increase significantly as an estimated 80,000 additional MRI exams will need to be performed each year and screening radiologists might have to increase their experience as the DENSE trial (November 2019 New England Journal of Medicine) involved the most experienced Dutch MR radiologists More installations will be required and need to be serviced and a shortage of qualified technicians exists when compared with contrast-enhanced mammography acquiring and viewing the exams is time-consuming It will be intriguing to see if this issue resurfaces in 2022 Ransomware attack on Irish health service causes disruption Imagine having to run an imaging service without a PACS -- that's the chilling prospect that faced Irish radiologists in May 2021 the government agency responsible for the publicly funded healthcare system in Ireland announced on 14 May that a "very sophisticated" ransomware attack had occurred and the HSE's IT systems had been shut as a "precautionary" measure "This has caused some disruption to our services Most healthcare appointments will go ahead as planned but x-ray appointments are severely affected," the HSE stated we know this is a variant of the Conti virus that our security providers had not seen before A ransom has been sought and won't be paid in line with state policy." first vice president of the ESR and consultant radiologist at Mercy University Hospital in Cork described the situation at his own facility "We can keep the bare minimum emergency service going for a few days, but it's a struggle, and very limited and limiting," he told AuntMinnieEurope.com We can do some imaging but can only view studies on modality-specific monitors -- e.g. view CTs on the screens in the CT scanning room The impact on radiology services has been "in a word consultant diagnostic and interventional radiologist and clinical director of radiology at the Mater Hospital in Dublin We are limited to looking at imaging on the scanners We are figuring out various workarounds to issue and communicate reports using various apps and in-house IT that is not connected to the internet," he said "Virtually all our IT systems that had any connection to the internet were shut down including our national PACS and other systems as well as email and lacking correlation and comparison with other studies." This disruption continued for several weeks and it came just when radiologists were working round-the-clock to tackle the backlog of scans resulting from the COVID-19 pandemic The incident has served as a warning and a wake-up call for the global imaging community about the devastating impact of cyberattacks on clinical practice Impact of specificity on cost-effectiveness of screening women at high risk of breast cancer with magnetic resonance imaging This German study showed that MR mammography (MRM) is a cost-effective alternative to mammography for yearly screening of high-risk cancer patients A team from the University Hospital of Mannheim found that screening with mammography versus MRM and treatment resulted in overall costs of $36,202 (31,948 euros) versus $39,051 (34,462 euros) and a cumulative effectiveness of 19.53 quality of life years (QALYs) versus 19.59 QALYs This led to an incremental cost-effectiveness ratio (ICER) of $45,374 (40,042 euros) per QALY for MRM "An interesting result from this study is that according to our analysis there are far less cost-effective imaging techniques than MR. A society that is willing to afford ultrasound as a screening tool should be far more willing to 'invest' in MRM," said lead author Dr. Clemens Kaiser, whose father, Prof. Dr. Werner Kaiser from Jena The authors also found that ultrasound and the combination of mammography and ultrasound had ICER values higher than the willingness to pay threshold (WTP) of $100,000 (88,257 euros) per QALY MRM was still cost-effective in screening high-risk patients as long as the technique's specificity did not drop below 86.7% A probabilistic sensitivity analysis also showed higher costs on average as well as higher effectiveness of the MRM strategy in high-risk patients Another analysis showed that a willingness to pay threshold of more than $30,400 (26,830 euros) per QALY indicated that MRM was cost-effective in most iterations While a direct comparison of mammography and MRM showed the latter had higher costs it also had a higher cumulative effectiveness in most cases Kaiser told AuntMinnieEurope.com last year that these results suggest that there is "seemingly no reason" not to use MRM as a screening tool for patients with dense breasts "Cost issues are one of the major concerns against using MRM in a broader set of indications which is why we have been trying to fill the data gap This paper indicates that MRM is diagnostically superior as well as cost-effective," he added It is important to mention that the data suggest that MRI should be performed by radiologists who are at least able to maintain 86% specificity in order to keep up the monetary advantage reliably This means that MR mammography should simply not be performed by just "anyone" MR mammography can only be as good as the radiologist reader," he said MR mammography could really be able to revolutionize breast cancer prevention." To read the whole article, go to the European Journal of Radiology website Magnetic resonance imaging incidents are severely underreported: A finding in a multicentre interview survey MRI-related incidents tend to be "greatly" underreported according to a Swedish study published in July in European Radiology A team led by MRI radiographer Johan Kihlberg from the Center for Medical Image Science and Visualization (CMIV) in Linköping major educational efforts are needed to enhance a culture of safety in MRI Researchers interviewed managing radiographers from 13 sites included in the study Questionnaires filled out by the radiographers showed that only 38% of incidents were reported formally suggesting that about 100 incidents remained unreported Among these incidents reported were radiofrequency burns but attitudes about expecting to be burned while working in the field imply that responders felt they were unnecessary to report "One site routinely reported scanned patients that later were found to have coins or paper clips in their clothing," researchers said "This reflects an accurate interpretation of Swedish law that defines incidents as 'Unwanted events that happened or could have happened.'  " About half of the responders were reportedly unaware of the EU directive 2013/35 which was adopted into the occupational health law in Sweden in 2016 the team also found that MRI knowledge increased because of the availability of MR physicists at the site Almost all radiographers in the study also expressed concern about MR safety knowledge for their respective radiologists "MR-specialized radiographers have a very diverse background MR knowledge varied substantially across the sites," the study authors wrote "The entire process of maintaining MR safety requires collaboration between different professions such as radiographers To read the entire article, go to the European Radiology website Unveiled in May 2021 the Somatom X.ceed CT scanner is adapted from the Somatom X.cite system that the company launched in 2019 but it can also perform all-around imaging The Somatom X.ceed system bundles the same technologies into a more powerful CT platform global product manager for CT marketing at Siemens Both systems also include tablet computers that enable technologists to control the scanner's operation remotely whether they are in the scanning room or the console room Many technologists have found the tablet controls useful during the COVID-19 pandemic X.ceed supports dual-energy spectral imaging but Siemens has broadened the spectral field of view to 50 cm This will give X.ceed users more flexibility in using spectral imaging but the company expects an initial emphasis on Europe and the U.S. with sales in China and Asia-Pacific to follow a spokesperson for Siemens said he could not disclose exact installation numbers but confirmed the new CT scanner has already been installed in "many locations globally and is used there clinically The Hyperfine Swoop is a 64mT machine intended mostly for head injuries It can be located in smaller and more crowded spaces such as the intensive care and stroke units The average scan for a patient is 35 minutes fluid-attenuated inversion-recovery (FLAIR) and diffusion imaging with 3D slices and millimetric resolution and the machine has to be integrated into the hospital's PACS As part of a research collaboration with the Bill & Melinda Gates Foundation Hyperfine has installed Swoop systems at King's College London and Cardiff according to the vendor's chief medical officer Dr. Khan Sidiqqui The company is currently in the process of applying for a CE Mark for the Swoop system "This solution is truly disruptive, in the sense that the technology allows for a paradigm change," said Mathieu Sarracanie, PhD, co-head of the Adaptable MRI technology center at the University of Basel, Switzerland, in a March 2021 article "It has a small footprint and is also mobile These machines don't need any specific siting and the cost is low The con is that these devices are purpose-built and some customers may see that as a disadvantage." he noted that gray- and white-matter contrast can show very high dispersion at lower field strength This has been explored by researchers at the University of Aberdeen who have generated some fascinating T1 contrast results in stroke patients thanks to a novel fast-field cycling MR scanner The 0.55T machine could be a serious contender to the standard 1.5T as it is more compact and cost-efficient Machines at even lower field strength will not replace MRI as we know it but will expand its use and bring it to other places that we don't know yet," Sarracanie added Spanish image analysis software developer Quibim was founded by Ángel Alberich-Bayarri Its qp-Prostate product is an AI program to aid in prostate MRI reporting The software received 510(k) clearance from the U.S Food and Drug Administration (FDA) in March 2021 qp-Prostate is an image processing program designed for use by radiologists specialized in prostate imaging Data and images are acquired through DICOM-compliant imaging devices and modalities qp-Prostate doesn't perform diagnostic functions it allows users to visualize and analyze DICOM data The imaging processing software is PI-RADS v2.1 compliant and runs on off-the-shelf workstations The software enables automated segmentation of the transitional zone and seminal vesicle regions of the prostate to aid in image interpretation and diagnoses Its application ultimately may reduce interpretation time and help define diagnosis per region Martí-Bonmatí, chairman of the radiology department and director of medical imaging at La Fe University and Polytechnic Hospital in Valencia, discussed the company's philosophy for developing AI in a session at ECR 2020. You can read that story here qp-Prostate is currently being deployed at hospitals in the U.S Originally launched as a video graphics developer for computer gaming, Nvidia took its first steps in the medical imaging field in 2009 when it developed a 3D ultrasound visualization system for expecting parents to see their unborn child company is working with King's College London in the U.K on an open-source framework called Medical Open Network for AI a toolkit for deep learning in healthcare imaging The first public release of the framework in 2020 provided domain-specific data transforms and evaluation methods for measuring the quality of medical imaging models The open-source code is based on the Ignite and PyTorch deep-learning frameworks and integrates libraries for tasks such as data processing Nvidia reports that MONAI can easily be added by researchers to their existing code; its customizable design enables modular components to be integrated into AI workflows Chief Technology Officer Jorge Cardoso of the King's College London AI Centre said in a recent blog post that such a comprehensive tool was missing prior to MONAI powerful and composable framework that allows them to do innovative medical AI research testing and documentation necessary for safe hospital deployment," he said The ultimate goal is to establish standardised practices for input and output processing and transformations as well as to define network architecture specific to healthcare imaging MONAI v0.6 became available in July 2021 A spin-off from the University of Cambridge in the U.K. Lucida Medical is developing artificial intelligence (AI) algorithms for cancer detection on MRI Lucida's initial product -- Prostate Intelligence (Pi) -- makes use of radiogenomics and image-processing techniques to analyze and detect cancer on prostate MRI images identifies candidate regions of interest for biopsy the software was estimated to enable a 7% reduction in missed prostate cancers and a 24% decrease in unnecessary biopsies Lucida launched a retrospective validation study of Pi in collaboration with Hampshire Hospitals NHS Foundation Trust The study will apply Pi to prostate MRI exams of up to 2,100 patients Lucida was co-founded in 2019 by AI expert CEO Antony Rix Rix is an entrepreneur with 25 years' experience in software development whose first startup was based on his PhD in machine learning and was acquired by Netscout in 2011 Sala is a cancer imaging specialist from the University of Cambridge Mark Hinton serves as the firm's chief technology officer having been the former chief technology officer at Image Analysis Group The firm is also a member of the ReIMAGINE prostate cancer consortium and has raised millions of pounds in a seed capital investment from a group of investors led by XTX Ventures and Prostate Cancer Research Lucida joined GE Healthcare's Edison Accelerator program which is aimed at supporting early-stage companies developing healthcare AI applications The company completed the integration of Pi with the NHS East Midlands Imaging Network (EMRAD) This work took place through GE Healthcare's 2021 EMEA Edison Accelerator Programme where Lucida Medical was one of six finalists selected from 350 applicants The result was announced on 30 November 2021 at GIANT Health 2021 in London Danish startup Radiobotics is creating a slew of artificial intelligence (AI) software applications to assess digital x-rays of bone and joints The company's first commercially available algorithm -- RBknee -- analyzes a standing postero-anterior knee radiograph to identify common radiographic findings associated with the diagnosis of osteoarthritis (OA): osteophytes Its machine-learning algorithms then conclude whether OA is present RBknee is suitable for use in orthopedic or radiological settings The software has received the CE Mark as well as U.S Food and Drug Administration 510(k) clearance Radiobotics is also developing other musculoskeletal radiology AI software applications RBmarker is designed as a quality-control tool for x-ray laterality markers while RBfracture evaluates x-rays for hip fractures The company's algorithms generate automated text reports and provide visual overlays on the images Radiobotics signed an agreement to make RBknee available on image exchange software provider TeleRay's platform Radiobotics has raised over $4 million (3.5 million euros) and was co-founded in 2017 by CEO Mads Jarner Brevadt and Chief Operating Officer Stine Mølgaard The company was also selected -- along with the other EuroMinnie Best New Vendor Finalist Lucida Medical -- for GE Healthcare's Edison Accelerator program Metrics details In the Dutch breast cancer screening program women recalled with a BI-RADS 0 score are referred for additional imaging while those with BI-RADS 4/5 scores are also directed to an outpatient breast clinic Approximately six out of ten women are recalled without being diagnosed with a malignancy these recalls require additional imaging and doctor visits which result in patient anxiety and increased health care costs Conventional types of imaging used for additional imaging are full-field digital mammography and tomosynthesis Contrast-enhanced spectral mammography has proved to have higher sensitivity and specificity than conventional imaging in women recalled from screening the aim is to study if CESM instead of conventional imaging is a more accurate and cost-effective strategy in the work-up of women recalled from breast cancer screening randomized controlled trial will be conducted at four centers and will include 528 patients recalled for suspicious breast lesions from the Dutch breast cancer screening program Participants are randomized in two groups: (1) standard care using conventional breast imaging techniques as initial imaging after recall versus (2) work-up primarily based on CESM Written informed consent will be collected prior to study inclusion The primary outcome is the diagnostic accuracy for detection of breast cancer Secondary outcomes are numbers of additional diagnostic exams Based on previously published retrospective studies we expect to demonstrate in this prospective multicenter randomized controlled trial that using CESM as a primary work-up tool in women recalled from breast cancer screening is a more accurate Netherlands Trial Register, NL6413/NTR6589 Conventional additional imaging may consist of additional (special) FFDM images or digital breast tomosynthesis (DBT) which can be combined with other imaging modalities Based on the findings during the imaging work-up tissue sampling might be recommended: either core needle biopsy (CNB) The total work-up in the evaluation of the recalled women can also be extended with breast magnetic resonance imaging (MRI) (e.g. in inconclusive findings) or 6 and/or 12 months follow-up with FFDM aiming to study whether a work-up using CESM instead of conventional imaging modalities such as FFDM or DBT (which is the current standard of care) for women recalled from screening is a more accurate The Rapid Access to Contrast-Enhanced spectral mammogRaphy (RACER) study is a multicenter Participants will be randomized in two study arms: (1) a control group undergoing standard care work-up of recalled women based on conventional imaging (such as FFDM or MRI) versus (2) work-up primarily based on CESM findings Four centers will participate in patient inclusion: the coordinating center Maastricht University Medical Center+ (Maastricht) Zuyderland Medical Center (Sittard-Geleen) and ethical approval) by the research team in Maastricht including the Principal Investigator and Study Coordinator Each center has a breast radiologist or surgeon as lead investigator and is assisted by other radiologists and technicians in that center for patient inclusion with randomization Training of new research team members will be done by the Study Coordinator The Study Coordinator also assists with and is responsible for correct data entry in all centers Central ethical approval has been confirmed from the Medical Research Ethics Committee of University hospital Maastricht and Maastricht University (decision no and we will not begin recruiting at other centers in the trial until local ethical approval has been obtained A data management system with electronic case report forms (eCRFs) is used to manage the clinical data of the participants in anonymous form by their trial identification number No biological specimens will be collected in this trial and storage are restricted to the research teams will be performed by the Clinical Trial Center Maastricht (CTCM) at each center before Since this study is marked as a “low-risk study” by the CTCM a data monitoring committee is not commissioned Interim analysis and premature termination of the study are not applicable; however periodic trial progress reports are requested by the main funders of the study each center will store all their study data for 15 years All women recalled for a suspicious breast lesion from our national screening program are eligible for inclusion Inclusion criteria are the ability to provide written informed consent and being recalled from breast cancer screening during the 18-month study inclusion period Excluded are women with a known allergy to iodine-based contrast agents and women at risk for developing contrast-induced nephropathy or women with known renal insufficiency The primary outcome will be the accuracy assessed by diagnostic performance parameters receiver operating characteristics (ROC) curve Radiologists will prospectively provide a single BI-RADS classification for each exam where a BI-RADS score of 1–3 will be considered ”benign” and 4-5 ”malignant” will be compared with the BI-RADS score given by the screening program The accuracy assessed by diagnostic performance parameters will be assessed after the next screening round after approximately 2 years Then the quality-adjusted life years (QALYs) will be modeled based on these utility scores Resource use related to diagnostics will be collected during the trial and iMTA Productivity Costs Questionnaire (iPCQ) Data from the digital questionnaires is automatically stored in the data management system Women will be randomized to undergo standard of care (control arm) or CESM (intervention arm) Minimization with stratification factors will be applied in the computer-generated randomization screening and enrollment application software ALEA (version 3.0.2083.212r; ALEA Clinical Randomization will be stratified by the following: predominant reason for recall (mass recall BI-RADS score (BI-RADS 0 versus BI-RADS 4/5) written consent will be conducted and data entry will be done by one of the research team members in each center to execute randomization using ALEA Should a problem occur in including a patient or randomization the Study Coordinator must be reached so that he can provide assistance patient and radiologist will be informed about the outcome; hence the radiologist is blinded for the outcomes between the two groups since the final diagnosis and pathology are not yet known The outcome assessors and data analysts are blinded for the judgment of the next screening round by the screening radiologists since accuracy also depends on the next screening round outcome Each participant is assigned a trial identification number for anonymization In each participant’s hospital patient file a statement will be noted about study participation and the assigned intervention or control group study participation can be ended during the follow-up phase Women undergoing standard of care will have their screening FFDM re-evaluated the breast is compressed between a paddle and detector plate The laterality of the breast and views per breast depend on the judgment of the radiologist At least one additional view of the recalled side will be performed FNAC) can be recommended to support or to invalidate suspicious findings on imaging the radiologist can consider follow-up in 6 and/or 12 months or single breast MRI The use of CESM is not permitted in this study arm CESM image of right breast in MLO view The white arrows indicate the suspect mass which is only visible on the recombined image and not in the low-energy image The high-energy image is not shown since it is not of clinical value Histopathological findings showed grade I invasive carcinoma benign masses; (4) (invasive) breast cancer or ductal carcinoma in situ (DCIS) The first three groups are defined as benign findings followed by cyst aspiration and a second FFDM of that breast to confirm that the lesion has disappeared Final diagnosis of (2) requires a minimum of one special view or DBT 6 and/or 12 months follow-up or breast MRI can be considered Final diagnosis for categories (3) and (4) is acquired with US-guided or stereotactic tissue sampling the subject will have a ”true positive” (TP) finding In subjects where no breast cancer or DCIS is diagnosed the follow-up period of 2 years will determine the true disease status If no interval cancers have been detected and the subject has not been recalled in the subsequent screening round the case will be considered a ”true negative” (TN) CESM and targeted US are performed including tissue sampling for pathological confirmation Left arm: standard care group; right arm: CESM group The primary objective of the study is to demonstrate that the use of CESM as a work-up tool for women recalled from breast cancer screening is more accurate compared to standard care consisting of conventional imaging The secondary objectives are to evaluate whether this novel approach is a more patient-friendly and cost-effective strategy in the work-up of women recalled from breast cancer screening requiring fewer days until final diagnosis and less additional imaging The course of scores on QoL with QALY and patient anxiety (STAI) from baseline over time at the six time points will be visualized and differences between groups will be tested using mixed linear models which account for correlations between repeated measurements Single and multiple imputation will be used to replace missing data Both intention-to-treat and per protocol analyses will be performed The per protocol population for the primary outcomes are those who got imaging exams based on their group allocation Women who underwent CESM in the standard care group are excluded from the per protocol analysis For the secondary outcomes this population can be further specified to those with questionnaires completed at six time points P values < 0.05 will be considered to indicate statistical significance Analyses will be performed with SPSS (version 25 Schedule of study activities according to Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) We present the rationale and design of the RACER study, which is a multicenter, prospective, randomized controlled trial investigating the work-up after breast cancer screening referral. This design is in accordance with the SPIRIT guidelines (Additional file 2) radiologists without any CESM experience (but with extensive experience in reading FFDM exams) performed as well as radiologists with CESM experience Reading a CESM exam does not require a dedicated learning curve Radiologists in the participating centers will have different levels of experience in reading CESM exams these works used a retrospective study design many other studies on CESM are retrospective in nature Only some studies collect data prospectively and most have not done so in a randomized controlled trial like the RACER study the difference in diagnostic accuracy is expected to increase again when CESM/US is compared with FFDM/US this has not been studied before in a prospective study design the patients’ mental state during the recall and diagnostic work-up is thoroughly assessed by validated questionnaires Due to the higher diagnostic performance of CESM especially in terms of reducing the number of false positive findings it is expected that in the intervention arm fewer additional exams will be performed These additional exams cause a delay in the assessment of final diagnosis and increase health care costs; plus we hypothesize that this will influence a patient’s mental state during these months the study design allows for a cost-effectiveness analysis showing us the impact on health care costs of both strategies during this period We hypothesize that using CESM as a work-up tool is more efficient and cost-effective than following current standard care an important hurdle is taken toward acquiring reimbursement by health insurance companies for CESM which at present frustrates the further introduction of CESM worldwide The LAR number for cancer mortality at this age is even 2–3 times lower Some even advocate that there is no effect of radiation under a dose of 100 mSv one may conclude that CESM exposure poses only a small additional risk compared to the lifetime risk for breast cancer incidence and mortality of 12,000 and 3000 cases per 100,000 women they also showed that occult cancers are being detected in 3–4% of the recalled women by using CESM the chance of finding occult (small) breast cancers is higher than the chance of having adverse reactions to contrast administrations (which are all documented in the RACER study) which in our opinion would justify the use of a CESM-based work-up of women recalled from screening we believe that the prospective multicenter randomized controlled RACER study will show that in recalled women a work-up based on CESM will be more accurate than usual care (based on conventional imaging such as FFDM) Higher specificity at similar sensitivity will reduce false positives and the volumes of additional diagnostic exams required to reach a final diagnosis ultimately leading to a decrease in health care costs and patient-experienced anxiety during this period Participants are currently enrolled via protocol version number 6.1 (April 23rd 2019) The study protocol was approved by the Medical Ethics Review Committee of Maastricht University Medical Center+ in January 2018 The first participants were randomized in April 2018 Enrollment is expected to be completed before January 1st will be shared on request and after approval by the study committee A part of the collected imaging and clinical data for which the patients will explicitly give informed consent will be shared with The D-Lab: Decision Support for Precision Medicine (GROW School for Oncology and Developmental Biology Maastricht University Medical Center) to be used in an additional artificial Intelligence analysis Receiver operating characteristics (curve) The Breast Imaging Reporting and Data System (BI-RADS) in the Dutch breast cancer screening programme: its role as an assessment and stratification tool Rijksinstituut voor Volksgezondheid en Milieu (RIVM) Uitvoeringskader Bevolkingsonderzoek Borstkanker Bilthoven: National Institute for Public Health and the Environment; 2018 Contrast-enhanced spectral mammography in patients referred from the breast cancer screening programme Effect of abnormal screening mammogram on quality of life Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program: validation of results in a large multireader Re-attendance at biennial screening mammography following a repeated false positive recall Potential cost savings of contrast-enhanced digital mammography Diagnostic accuracy of contrast-enhanced spectral mammography in comparison to conventional full-field digital mammography in a population of women with dense breasts Diagnostic performance of dual-energy contrast-enhanced subtracted mammography in dense breasts compared to mammography alone: interobserver blind-reading analysis Contrast-enhanced spectral mammography as work-up tool in patients recalled from breast cancer screening has low risks and might hold clinical benefits EuroQol Research Foundation. EQ-5D-5L User Guide: basic information on how to use the EQ-5D-5L instrument [Internet]. 2015. https://euroqol.org Dutch tariff for the five-level version of EQ-5D Manual for the Self-Assessment Questionnaire: the Dutch version of Spielberger’s State-Trait Anxiety Inventory Outcomes in Cochrane systematic reviews addressing four common eye conditions: an evaluation of completeness and comparability Evaluation of tumor angiogenesis of breast carcinoma using contrast-enhanced digital mammography Assessing the risk of contrast-induced nephropathy using a finger stick analysis in recalls from breast screening: the CINFIBS explorative study Radiation exposure of contrast-enhanced spectral mammography compared with full-field digital mammography Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging in women with known breast carcinoma Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version 3.01. updated 2013/06/04 [Internet]. 2013. www.openepi.com Sampling variability of nonparametric estimates of the areas under receiver operating characteristic curves: an update Zorginstituut Nederland. Guideline for economic evaluations in healthcare [Internet]. 2016. https://www.zorginstituutnederland.nl Bouwmans C, Hakkaart-van Roijen L, Koopmanschap M, Krol M, Severens H, Brouwer W. Handleiding iMTA Productivity Cost Questionnaire (iPCQ) [Internet]. Rotterdam: iMTA, Erasmus Universiteit; 2013. https://www.imta.nl/questionnaires/ Update of the Dutch manual for costing studies in health care Diagnostic performance of contrast-enhanced spectral mammography: systematic review and meta-analysis Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader contrast-enhanced spectral mammography and ultrasonography in a group of 116 patients Diagnostic value of contrast-enhanced spectral mammography for screening breast cancer: systematic review and meta-analysis Utility of routine use of breast ultrasound following contrast-enhanced spectral mammography Dual-energy contrast-enhanced digital mammography in routine clinical practice in 2013 Breast radiation dose With CESM compared with 2D FFDM and 3D tomosynthesis mammography Comparative dose of contrast-enhanced spectral mammography (CESM) Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2 Download references The authors gratefully acknowledge the contributions of Jose Maessen and the patient panel representatives of the Maastricht University Medical Center+ Oncology Centre primo loco authorships will be divided between LN The remaining authors will be based on inclusion rates; all authors must meet the guidelines for authorship: to have made substantial contribution to the study and agreed to be accountable for the scientific content There will be no use of professional writers This study received grant support from the Netherlands Organization for Health Research and Development (ZonMw grant number 843001801) and the Department of Radiology and Nuclear Medicine of the Maastricht University Medical Center+ The University hospital Maastricht (MUMC+) is the owner of all data and rights to publication Department of Radiology and Nuclear Medicine GROW School for Oncology and Developmental Biology Department of Clinical Epidemiology and Medical Technology Assessment and IH drafted the original version of the study protocol All other authors contributed equally to revision of the manuscript All authors read and approved the final manuscript ML receives grant support by Bayer and GE Healthcare He has also received several speaker fees from GE Healthcare JW receives institutional support from Agfa He is also a speaker for Bayer and Siemens All the other authors declare that they have no competing interests Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Informed consent form RACER study in Dutch Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 checklist Download citation DOI: https://doi.org/10.1186/s13063-019-3867-5 Anyone you share the following link with will be able to read this content: a shareable link is not currently available for this article Akshay Sarathi gets ready to teach in one of anthropology class at Jack E Brown Chemical Engineering Building in room 102 on Monday Aggies have the chance to learn anything they want Here is a list of some of the courses Texas A&M students are most excited about this spring This class covers the basics of identifying different Texan soils and their uses. The course description explains the course will cover the “field study of morphological features of soil profiles.”  Environmental geosciences senior Amy Crook said the class focuses on  identifying different soils and their textures and understanding their capabilities. She explained that the course is very hands-on and does an excellent job of helping students apply what they are learning. She is most excited about going to the A&M Beef Cattle Center to make field observations “I’m excited because I hadn’t taken this class prior to [joining the] soil judging team,” Crook said “It’s fun to learn about new things that have to do with the soil the soil fractions and how the environment affects the soil.” As a course discussing special topics in a certain field, it is not available in the regular engineering course catalog. This spring, the course is taught byKamran Entesari, Ph.D., a long-time researcher in the field of radio frequency waves Electrical engineering junior Lewis Walter said he felt the classwork was useful He described it as working on the older model of a radio and understanding how each antennas He said there’s relevance in studying radios and their signals in modern times “[The class material] has actual practicality to it,” Walter said “What makes [this] course so interesting is that we use radio with everything even today.” Walter said the course focused on philosophical topics from the late 1800s to postmodernism and students were currently discussing feminist theory and the intricacies of power dynamics.  As someone who is pursuing a minor in philosophy Walter said he was really excited about learning something different than his engineering coursework “It’s a very broad topic and can go many different ways,” Walter said “I love looking at the implications of what people are saying and how it abstractly applies to other aspects.” Cross listed both in the English and women’s & gender studies’ course catalogs, this course focuses on the history of women in English literature. As stated in the course description ENGL 374 focuses on the “significance of gender in the racial sexual and cultural contexts of women writing in English.” English senior Hannah Barber is taking the course this semester partly due to her degree plan and partly due to her interest in the course material. Barber said she credits her  interest in the material to professor Nancy Warren’s, Ph.D. “She is so enthusiastic and upbeat,” Barber said “It’s to the point where [the class] is all fighting to answer [Warren’s] questions.” This class covers the development of various cinematic movements, periods and styles. The course description speaks of working with national cinemas as well.  General engineering freshman Elsa Silva said she has a passion for theatre and wanted to learn more about its development through the ages Silva said the course relied heavily on students’ analysis of specific scenes in films and said she is looking forward to the mood board creation assignments.  “I really wanted to learn where certain techniques and tactics [of theatre] come from,” Silva said “[I recommend this class] to anyone who has a general appreciation for the arts.” Offered by the A&M Financial Planning Program starting in 2017, this course is a great way for students to learn practical financial knowledge while earning academic credit hours. The course description says the course is offered in person and asynchronously online so students can learn in whichever way works best for them Biological and agricultural engineering junior Emma Lobbes talked about the ‘What is my net worth?’ worksheet students are assigned and the real world value of the course material She said is taking the course purely for the importance of the information and encouraged all students to do the same “You get a good foundation before you leave college and have to make all those huge decisions that affect the rest of your life,” Lobbes said.  Your donation will support the student journalists of Texas A&M University - College Station Your contribution will allow us to purchase equipment and cover our annual website hosting costs in addition to paying freelance staffers for their work Cancel reply Family owned and operated for over 85 years went to their heavenly home and were received into the loving arms of their faithful Savior within the same week was a respected drywaller in the Grand Rapids area for many years He was actively involved in sports for his girls and grandsons and an avid sports fan Ruth graduated from Blodgett Hospital’s Nursing School and worked there as a nurse for many years John and Ruth loved serving their Lord and his people through their church and Bible Study Fellowship They will be lovingly remembered by their children Daniel and Kaley Jipping; one great-granddaughter Lillian Ruth Jipping; John’s brothers and sisters Edna Snoeyink; and many nieces and nephews The burial will take place at Grandville Cemetery Relatives and friends may meet the family Sunday at Matthysse Kuiper DeGraaf Funeral Home (Grandville) 4145 Chicago Dr Those who wish may make memorial contributions to BSF International or Faith Hospice MKD - Grandville4145 Chicago Dr. SWGrandville, MI 49418Get Directions Phone: (616) 534-8656 Hope CRC3110 Barrett Ave SWGrandville, MI 49418Get Directions Designer’s Choice Grand Vase Arrangement 616.724.1800 | Contact Us | Careers | Customer Reviews | Delivery/Refund Policy | © 2025 MKD Funeral Homes Upon completing your online flower order, our florist will immediately receive the details of your purchase. Our florist will then prepare your arrangement(s) with care and make the delivery to the location you provided during the ordering process. If you experience any problems with the product you ordered, please contact our business office by email at admin@mkdfuneralhome.com Contrast-enhanced mammography (CEM) may be an alternative to breast MRI for preoperative staging of invasive lobular carcinoma, suggests findings published on 13 May in the European Journal of Radiology from Maastricht University in the Netherlands found that both imaging methods overestimate tumor size in patients diagnosed with invasive lobular carcinoma as well as have no significant difference in diagnostic odds ratios between the two demonstrate a statistically significant improvement in specificity preoperative staging of invasive lobular carcinoma using CEM instead of MRI has a comparable diagnostic performance not only when assessing maximum tumor size but also for the detection of multifocal and/or contralateral breast cancer foci," Lobbes and co-authors wrote About 10% of breast cancers are invasive lobular which is more frequently tied to multifocal and contralateral breast cancer This type also has histologic characteristics that make it difficult to detect on conventional imaging methods These include stromal invasion by single files of cells and little disturbance to nearby breast architecture Accurate preoperative staging is important in determining the best treatment strategies Previous research suggests that breast MRI is most accurate in tumor sizing the technology is not as accessible as other imaging modalities and can be labor-intensive Previous studies also suggest that CEM measures up to breast MRI in terms of tumor sizing and detecting cancers Lobbes and colleagues wanted to put the two modalities to the test They investigated the agreement between the two for measuring tumor size as well as compared their ability to detect multifocal invasive lobular carcinoma and contralateral breast cancer foci The study included 305 invasive lobular carcinoma cases from women with an average age of 63.7 years The researchers noted that preoperative staging was done using MRI in 266 cases and CEM in 77 cases They found that MRI overestimated tumor size by 1.5 cm while CEM did the same by 2.1 mm The authors wrote that size measurements for invasive lobular carcinoma tend to become less accurate in larger tumors above 3 cm the risk of involved surgical margins increases," they wrote The team also found that while MRI had the advantage for sensitivity that difference wasn't significantly different showed higher specificity and the difference was statistically significant And the modalities also demonstrated comparable sensitivity and specificity for contralateral breast cancer The team also found that CEM showed higher diagnostic odds ratios for both multifocal disease and contralateral breast cancer compared to MRI it deemed these differences to be non-significant (p = 0.56 and p = 0.78 The study authors also wrote that they are preparing a related study where women undergo both CEM and MRI in a short time window prospective data for "sufficient statistical power." they affirmed that their published study showed that CEM is able to match breast MRI's performance for assessing tumor size and diagnosing multifocal or contralateral breast cancer Disclosure: Lobbes received several speaker's fees and a research grant from GE Healthcare Co-author Dr. Joachim Wildberger from the university received institutional grants and speaker's fees from Agfa Although advocates of contrast mammography won some converts breast MRI was still preferred as the main breast cancer screening option for intermediate-risk women in a March 2 debate between advocates of the two technologies at the ECR Overture researchers took several minutes to state their cases from Radboud University Medical Center in the Netherlands from Zuyderland Medical Center in the Netherlands spoke in support of contrast-enhanced mammography Mann focused on MRI's high sensitivity and promising advancements in specificity which has long been a shortfall of the technique in clinical use Large studies that Mann cited and took place between 2010 and 2020 saw specificities ranging from 83% to 98.4% Mann also used comparative studies that support MRI's use over contrast-enhanced mammography and node-negative," Mann said of breast MRI including radiation exposure and the discomfort patients face with breast compression In a 2021 Plus Magazine article Mann cited 90% of surveyed women indicated their dissatisfaction with conventional mammography for breast screening "The clear message there is to get rid of the painful mammogram why on Earth would we go back to contrast-enhanced mammography screening for this population?" said Mann who is also an executive board member of the European Society of Breast Imaging For his part of the debate, Lobbes talked about contrast-enhanced mammography having superior specificity. A meta-analysis from 2020 that he cited showed that while both methods had a pooled sensitivity of 97% mammography's specificity was 66% compared with 52% for MRI He also talked about mammography's timely convenience for patients at about 15 minutes on average for imaging compared with 25 minutes for MRI. While abbreviated MRI can image patients in about four minutes on average Lobbes said this doesn't account for additional imaging needed for suspicious lesions "You also have the disadvantage of needing to have two appointments," he said Equipment for contrast-enhanced mammography is cheaper than that of MRI He pointed to mammography machines costing about 350,000 euros ($389,000) with an additional 25,000 euros ($28,000) dedicated toward maintenance cost about 1.5 million euros ($1.7 million) along with 150,000 euros ($167,000) for annual maintenance Mann cited a 2020 study by Geuzinge et al in JAMA Oncology that found MRI screening every 18 months for women with a family history of breast cancer and between the ages of 35 and 60 is cost-effective for all densities Audience members were tasked with voting on which modality they favored before and after the debate breast MRI had 69% of audience support with the other 31% going to contrast mammography with MRI winning 63% of support with contrast mammography having 37% of audience support Mann and Lobbes acknowledged that both imaging methods are valuable but that more evidence is needed in screening data "There can be room for both techniques," Lobbes said "We should really emphasize where the biggest advantage is in patient care whether that be MRI or contrast-enhanced mammography." A combination of contrast-enhanced mammography with ultrasound performs as well as breast MRI for preoperative staging for breast cancer, according to a Dutch study published on 2 August in the European Journal of Radiology The study findings suggest that an effective "one-stop-shop" imaging strategy is available to clinicians and their breast cancer patients wrote a group led by first author Dr. Marc Lobbes director of the breast imaging center of the Zuyderland Medical Center in Sittard-Geleen "Breast MRI is hardly necessary when contrast-enhanced mammography in combination with ultrasound has been performed as a single appointment imaging strategy in breast cancer patients," wrote Lobbes who is a member of the scientific counsel of the Dutch Expert Center for Screening and an educational board member of the European Society of Breast Imaging (EUSOBI) Radiologists use preoperative imaging to assess the extent of disease in women with newly diagnosed breast cancer and to stage treatment Contrast-enhanced mammography is a relatively new imaging method and previous research has touted it as a way to increase the diagnostic accuracy of mammography It has also been found to be at a lower cost than MRI Lobbes and colleagues conducted a literature review to assess the value of combining contrast-enhanced mammography with targeted ultrasound in a single appointment They found that contrast-enhanced mammography performs equally well to MRI in measuring tumor sizes with the sensitivity of both approaches being comparable in detecting breast cancer mammography shows more specificity than breast MRI which translates to slightly fewer false-positive findings in preoperative staging Contrast-enhanced mammography exam of both breasts in two views an ill-defined mass can be seen in the upper outer quadrant of the right breast at the location of a palpable mass in a 52-year-old patient D) of a contrast-enhanced mammography examination The recombined images show an irregular enhancing mass in both breasts -- both in the upper outer quadrant Tissue sampling revealed a bilateral invasive breast cancer of no special type A breast MRI examination performed prior to surgery also confirmed the presence of two irregular enhancing masses on these contrast-enhanced T1 weighted images (E: top example is the cancer in the right breast; bottom example is the left breast) All images courtesy of Dr. Marc Lobbes The group also noted that axillary ultrasound can be performed during the same appointment as contrast-enhanced mammography and shows equal performance compared with evaluating the axilla on standard breast MRI A previous study found that breast MRI tended to slightly overestimate tumor size by about two millimeters on average while contrast-enhanced mammography did not Other studies the team cited showed comparable accuracy between the two approaches Lobbes and colleagues also concluded based on previous research that no evidence exists to support supplemental breast MRI for more accurate appraisal of the axillary lymph nodes when ultrasound was already performed earlier One potential downside of combining contrast-enhanced mammography with ultrasound may be missing internal mammary lymph node metastases since they are not in the field of view of any mammographic image they also wrote that the consequences of "missing" these metastases by any kind of imaging modality are limited in terms of treatment and prognosis The only exceptions to consider breast MRI over other imaging methods for preoperative staging include patients with lobular cancer an allergy for iodinated contrast agents and renal insufficiency or when breast lesions are not within the mammographic field of view clinicians can consider using contrast-enhanced mammography "When considering the combination of contrast-enhanced mammography and ultrasound as a single appointment imaging strategy for preoperative staging of breast cancer there is only limited room for an additional benefit of breast MRI," the authors concluded A deep-learning model can accurately identify and describe suspicious lesions on contrast-enhanced mammography (CEM) images according to research published June 20 in Radiology from Maastricht University in the Netherlands also found that their algorithm when combined with handcrafted radiomics models "Our identification and classification model performed at a level that would make it potentially generalizable," Lobbes and colleagues wrote While deep-learning models and handcrafted radiomics models have been shown to perform well individually for breast imaging the researchers noted a lack of data on their combined performance Lobbes and colleagues trained their deep-learning with reprocessed low-energy and recombined images for automatic lesion identification The researchers wanted to test their comprehensive tool on CEM images from women who are recalled They also trained a handcrafted radiomics model to classify both human- and deep learning-segmented lesions and combined it with the deep-learning model The team included retrospective data from 1,601 women It used CEM images of suspicious breast lesions for a training set of 850 women and a test set of 212 women for the deep-learning model The model identified 99% of lesions on an external dataset (n = 279 women) The researchers found that in the external dataset the deep-learning model achieved a lesion identification sensitivity of 90% and 99% at the image and patient level It also achieved an average Dice coefficient of 0.71 and 0.80 at the aforementioned levels the team reported that the deep-learning model combined with the handcrafted radiomics model achieved an area under the curve (AUC) of 0.88 when using manual segmentations When using deep learning-generated segmentations The study authors suggested that one future direction to support the model's use is to conduct a follow-up study replacing CEM images with full-field digital mammography images and compare findings In an accompanying editorial from the Massachusetts General Hospital wrote that with AI techniques for CEM representing "uncharted territory," further research is needed They added that this could help address current shortcomings in this area validate the models across different practices and CEM vendors and assess their impact on real-world clinical practice The co-authors also wrote that deep-learning techniques "need not rely" on handcrafted radiomics since incorporating such features in deep-learning models may introduce human biases The study can be found in its entirety here Metrics details Contrast-enhanced mammography (CEM) has shown to be superior to full-field digital mammography (FFDM) but current results are dominated by studies performed on systems by one vendor Information on diagnostic accuracy of other CEM systems is limited we aimed to evaluate the diagnostic performance of CEM on an alternative vendor’s system We included all patients who underwent CEM in one hospital in 2019 except those with missing data or in whom CEM was used as response monitoring tool Three experienced breast radiologists scored the low-energy images using the BI-RADS classification the complete CEM exams were scored similarly Histopathological results or a minimum of one year follow-up were used as reference standard Diagnostic performance and AUC were calculated and compared between low-energy images and the complete CEM examination for all readers independently as well as combined Breast cancer was diagnosed in 23.0% of the patients (35/152) overall CEM sensitivity increased from 74.3 to 87.6% (p < 0.0001) specificity from 87.8 to 94.6% (p = 0.0146) AUC increased from 0.872 to 0.957 (p = 0.0001) similar to earlier studies mainly performed on another vendor’s systems both sensitivity and specificity improved when compared to FFDM The use of CEM in the breast imaging community is steadily increasing as is not only reflected by the increasing number of installations and scientific literature but also by the fact that multiple vendors now have their own commercially available mammography systems capable to perform CEM some of these studies focused on other topics than diagnostic accuracy (e.g. or CEM as response monitoring tool in women treated with neoadjuvant chemotherapy) To facilitate a broader acceptance of CEM in clinical practice it is important to study the consistency and reproducibility of results it is unethical to have women undergo more than one CEM exam solely for this research purpose the aim of this retrospective study was to evaluate the diagnostic performance of FFDM versus CEM on a Hologic system using three different readers The CEM system used was installed in January 2019 and the first clinical CEM was performed in February 2019 All consecutive patients who underwent CEM in the period of February to December 2019 were eligible for this retrospective study Indications for CEM imaging included: additional imaging after screening recall screening of women with hereditary breast cancer when breast MRI was contra indicated patients with symptoms which raise suspicion of breast cancer (e.g. inconclusive findings after prior breast imaging and coincidental findings in non-breast specific imaging (e.g. Excluded were patients who were treated with neoadjuvant chemotherapy where CEM was solely used as response monitoring tool The Medical Research Involving Human Subject Act (WMO) did not apply to this study protocol and an official approval of this study by the Medical Ethics Review Committee of University hospital Maastricht and Maastricht University (METC azM/UM) was not required (decision no Due to the retrospective nature of the study the METC azM/UM and the Trial Advisory Committee of Laurentius Hospital (decision no 20/10) waived the requirement for obtaining informed consent All methods were carried out in accordance with relevant guidelines and regulations Guerbet) was administered (dose 1.5 mL/kg body weight followed by saline flush) using a power injector (MEDRAD Stellant All CEM exams were performed on a single dedicated mammography system (Selenia Dimensions the radiologists were allowed to adjust their initial BI-RADS classification if deemed necessary All readers were blinded for each other’s classifications and the final diagnosis The breast density classification was retrieved from the imaging reports All histological analysis were performed according to our current national guidelines The maximum diameter of the breast cancer diagnosed and axillary lymph node status were retrieved from the pathology reports A minimum of one year follow-up was used in the final analysis as additional reference standard for cases that were considered benign (including cysts) or negative after CEM evaluation in order to identify any false negative imaging results If no cancer was diagnosed after this period the case was definitely considered benign or negative Statistical significance was set at p values ≤ 0.05 Statistical analyses were performed using SPSS (IBM Corp A detailed overview of image indications and diagnoses is presented in Table 1 The ten excluded patients had received CEM to monitor tumor response during neoadjuvant chemotherapy treatment (n = 4) or had incomplete CEM data (n = 6) Most patients (95/152; 62.5%) were referred to the hospital for additional imaging after a recall from the national breast cancer screening program All patients underwent treatment for their (pre-) malignancy the majority with primary surgery (n = 30) and surgery after neo-adjuvant chemotherapy (n = 2) In one case the patient did not undergo surgery and in two other cases the patients were operated elsewhere The mean tumor diameter of the operated 34 lesions was 12.4 mm ± 6.9 (range 0–29 mm) Axillary lymph node status was pN + in seven cases Median follow-up of CEM exams initially classified as benign/negative was 25 months (range 17–28 months) no additional breast cancer diagnoses were established in these cases classifying them as definitely benign/negative ROC curves and corresponding AUC values for LE and CEM (A) Reader 1; (B) Reader 2; (C) Reader 3; (D) All readers combined bottom row represents the recombined images round mass anterior to the pectoral muscle (white arrow) an ill-defined mass can be observed in the retro areolar zone with spiculated margins also showing enhancement on the recombined images (B2 none of the radiologists classified this case as malignant ill-defined focal asymmetry at the site of the yellow arrow The distortion did not show any enhancement D1 and D2 show a negative case (no abnormalities or focal enhancement visible in the breast) this patient suffered from an axillary lymphoma and was therefore classified as ‘negative’ B and C were invasive carcinoma of no special type these results are mainly based on studies performed on GE Healthcare systems we demonstrated that an increase in diagnostic performance can also be achieved with a Hologic system when compared to FFDM sensitivity significantly increased from 74.3 to 87.6% we concluded that sensitivity and specificity for CEM on a Hologic system are in line with prior findings for sensitivity and specificity of CEM studies that were mainly performed on GE Healthcare equipment Reproducibility is one of the pillars in science this means that certain results obtained can be achieved again (‘reproduced’) when the study is repeated with a similar methodology but by other since no claim can be proven by a single published study Despite the utmost efforts of investigators to perform a study to the best of their ability reproducible results provide the scientific community the only true transparency in results giving us confidence in the results as well it is important to reproduce the claims of CEM superiority over FFDM mainly made on GE Healthcare equipment as this creates confidence that the results stand even when other equipment is used the differences in methodologies used in these studies hamper a robust comparison of our results with these eleven studies prolonging follow-up will not result in significant alterations of the study conclusion this study showed that CEM performed on a Hologic system improved both sensitivity and specificity when compared to FFDM Our observed diagnostic performance falls within the 95% CI of summary ROC curves of a previously published meta-analysis it can be safely assumed that the type of CEM unit does not seem to be a decisive factor in studies that are using equipment from different vendors The dataset generated and analysed during the current study are available from the corresponding author on reasonable request Contrast-enhanced mammography: State of the art Contrast-enhanced spectral mammography in women with intermediate breast cancer risk and dense breasts Performance of dual-energy contrast-enhanced digital mammography for screening women at increased risk of breast cancer Diagnostic value of contrast-enhanced spectral mammography for screening breast cancer: Systematic review and meta-analysis Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis protocols and adverse reactions for contrast-enhanced spectral mammography (CESM): A systematic review Contrast-enhanced spectral mammography (CESM) Contrast enhanced spectral mammography: A review Low energy mammogram obtained in contrast-enhanced digital mammography (CEDM) is comparable to routine full-field digital mammography (FFDM) Evaluation of low-energy contrast-enhanced spectral mammography images by comparing them to full-field digital mammography using EUREF image quality criteria Methods for calculating sensitivity and specificity of clustered data_a tutorial Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach mammography and MRI—Clinical performance in a multi-reader evaluation Contrast-enhanced spectral mammography (CESM) versus breast magnetic resonance imaging (MRI): A retrospective comparison in 66 breast lesions and contrast-enhanced mammography in women with newly diagnosed breast cancer Diagnostic value of contrast-enhanced digital mammography versus contrast-enhanced magnetic resonance imaging for the preoperative evaluation of breast cancer Diagnostic performance of contrast-enhanced spectral mammography: Systematic review and meta-analysis Contrast enhanced digital mammography (CEDM) helps to safely reduce benign breast biopsies for low to moderately suspicious soft tissue lesions Contrast enhanced digital mammography versus magnetic resonance imaging for accurate measurement of the size of breast cancer Evaluation of contrast-enhanced digital mammography (CEDM) in the preoperative staging of breast cancer: Large-scale single-center experience Contrast-enhanced digital mammography: A single-institution experience of the first 208 cases Contrast-enhanced digital mammography in the surgical management of breast cancer Contrast-enhanced mammography in the evaluation of breast calcifications: Preliminary experience Clinical utility of contrast-enhanced spectral mammography as an adjunct for tomosynthesis-detected architectural distortion Digital breast tomosynthesis and contrast-enhanced dual-energy digital mammography alone and in combination compared to 2D digital synthetized mammography and MR imaging in breast cancer detection and classification Architecture distortion score (ADS) in malignancy risk stratification of architecture distortion on contrast-enhanced digital mammography Netherlands comprehensive cancer organisation (IKNL). Monitor bevolkingsonderzoek borstkanker. 1–6 https://www.iknl.nl/borstkankermonitor (2020) Download references This study has received funding by the Netherlands Organization for Health Research and Development (ZonMw Efficiency Studies Grant Number 843001801) All authors participated in the study design ML received several research grant and speaker’s fees from GE Healthcare JW received institutional grants and speaker’s fees from AGFA The other authors declare no competing interests Download citation DOI: https://doi.org/10.1038/s41598-021-01622-7 Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research Inland Real Estate Group was honored with a Special Recognition Award by The Conservation Foundation for managing the sale of a sensitive area of land along the Fox River Chairman and CEO Dan Goodwin was instrumental in rescuing the sale of 300 acres along the Fox River south of Yorkville nestled between Silver Springs State Park and Hoover Forest Preserve It's the largest property along that stretch and was critical to connect the open space areas Along with assistance from The Conservation Foundation Inland worked with an environmentally conscious purchaser to successfully engineer a sale and the Kendall Forest Preserve District is now interested in the land to connect with Hoover Forest Preserve The award was accepted by Inland Development President Anthony Casaccio at The Conservation Foundation's Spring Luncheon at Fishermen's Inn in Elburn last month is one of the nation's leading providers of commercial real estate services The Conservation Foundation is one of the region's largest and oldest private conservation organizations - with more than 4,000 members and donors and more than 500 volunteers who contribute 20,000 hours per year Work is focused in DuPage, Kane, Kendall and Will counties to preserve and restore nature in your neighborhood. Find out more at theconservationfoundation.org Hopkins senior left-hander Zach Brechting posted a 7-2 record and 1.65 ERA this spring Talented players with plenty of versatility and hitting skills highlight this year’s Advance South All-Area Baseball Team This year’s squad features a blend of speed along with a number of players who provided solid innings on the pitching mound An all-conference and all-district honoree his first three years Bentancourt turned in a record-breaking junior season as he hit .518 with a 3.29 ERA and 59 strikeouts in 52 innings pitched “Pete broke the school record for hitting as a third baseman and shortstop,” said Lee coach Ty Emelander “He is also a very good pitcher who was always matched up against the other team’s No Brechting provided a big impact for the Vikings Brechting went 7-2 this season with a 1.65 ERA and 100 strikeouts “Zach was one of our workhorse pitchers,” said Hopkins coach Pat O’Dell 1 pitcher and did really well at the plate for us Along with leading the team in most offensive categories Bresso provided versatility in the field with his ability to catch “Leo was a leader for us this year,” said Godwin Heights coach Troy Maleport “He did whatever he could to help the team It was a great experience to watch Leo mature as a hitter throughout the years really coming into his own at the plate this year.” Dykstra did the job in the field and at the plate “Mitch was the sparkplug at the top of our order and did an amazing job battling at the plate and putting the ball in play as is evident by only striking out six times all season,” said Wayland coach Travis Wilcox “He was our most consistent defender and was responsible for saving several runs throughout the season with his amazing play.” who will be playing baseball at Hope College earned all-conference honors with his mix of fine defense and production on offense “Ethan was one of the best defensive second basemen in the area with tremendous range and a strong arm to turn the double play,” said Byron Center coach Brent Gates “Ethan hit in the middle of the lineup and came up with many clutch hits for us.” Lobbes wrapped up his career at South Christian by earning all-conference honors with a 0.94 ERA and 53 strikeouts in 51 innings pitched “Matt has the ability to dominate on the mound when his stuff is working,” said South Christian coach Brian Braat he came up big numerous times with extra-base hits.” Nickelson was also named Kelloggsville’s Male Athlete of the Year A versatile player who also pitches and can play catcher with a .489 on-base percentage and .630 slugging percentage He drove in 32 runs for the Rockets and added 13 doubles “Gage hit the ball pretty consistently this year,” said Kelloggsville coach Drew Lakatos Gage is somebody we count on to do the little things and help the younger kids on the team.” A three-time all-conference and two-time all-district player Purnell provided Wyoming with outstanding defense and the ability to impact the game in a number of ways on offense playing four years for us and doing lots of great things,” said Wyoming coach Shawn Veenstra and was always upbeat with his teammates.” Roede is a two-time all-conference and all-district player “Nate was a tremendous leader both on and off the field,” said Byron Center coach Brent Gates An impact player both on offense and defense Willemsen earned all-conference and all-district honors this season “Jacob is a tremendous asset with his speed both offensively and defensively,” said Byron Center coach Brent Gates “He was a sparkplug at the top of our lineup He committed no errors all year in center field.” Use of and/or registration on any portion of this site constitutes acceptance of our User Agreement, (updated 8/1/2024) and acknowledgement of our Privacy Policy, and Your Privacy Choices and Rights (updated 1/1/2025) © 2025 Advance Local Media LLC. All rights reserved (About Us) The material on this site may not be reproduced except with the prior written permission of Advance Local Community Rules apply to all content you upload or otherwise submit to this site YouTube's privacy policy is available here and YouTube's terms of service is available here Ad Choices Volume 15 - 2024 | https://doi.org/10.3389/fimmu.2024.1399180 Primary humoral deficiency and secondary B-cell depletion may lead to prolonged Sars-Cov-2 infection due to a decreased viral clearance Prolonged infection is mainly driven by the lack of anti-Sars-Cov-2 immunoglobulin (IVIg) especially in patients with no vaccine response Anti-spike immunoglobulin can be provided by infusion of convalescent patients’ plasma: recent studies highlighted that commercial immunoglobulin show high titers of neutralizing IgG We conducted a single center retrospective cohort median age 74 years old): one patient with X-linked agammaglobulinemia and 8 patients treated with rituximab (2 granulomatosis with polyangiitis 4 low grade B-cell lymphoma and 1 EBV post-transplant lymphoproliferative disorder) 7/8 had received at least 3 doses of mRNA anti-Sars-Cov-2 vaccine (median 4) with no response (anti-Spike IgG 0 for 6 patients) In this specific population requiring oxygen therapy but no intensive care support the administration of IVIg was well tolerated and provided a swift improvement of clinical status a significant decrease of inflammation associated to the an improvement of radiological patterns Our results suggest that immunoglobulin could be used as a salvage therapy as an alternative to convalescent plasma but highly stringent patient selection is required due to the worldwide shortage of IVIg We conducted a retrospective monocentric study in the Internal Medicine department of Clermont-Ferrand Estaing University Hospital from 01/01/2021 to 15/12/2023 The study was conducted in accordance with the Helsinki declaration and approved by local the Ethics Committee (International Review Board 00013412 “CHU de Clermont Ferrand IRB #1” IRB number 2023-CF240) with compliance to the French policy of individual data protection Inclusion criteria were adult immunocompromised patients characterized by: (i) primary or secondary B-cell depletion associated with reduction in serum immunoglobulin G (< 5 g/L) (ii) poor vaccine response or refusal of vaccination Sars-Cov-2 infection was detected by PCR on nasopharyngeal swabs or by bronchoalveolar lavage Table 1 summarizes the characteristics of the population 8/9 had secondary immunodeficiency associated with rituximab therapy: 3 patients were treated for autoimmune diseases (2 for granulomatosis with polyangiitis and 1 patient received various immunosuppressive drugs for pulmonary transplantation and rituximab for EBV associated Post-transplant lymphoproliferative disorder The last patient (#9) was treated with low dose intravenous immunoglobulin for X-linked agammaglobulinemia (CD19 0/mm3) Table 1 Characteristics of adult immunocompromised patients with B-cell depletion and Sars-Cov2 infection treated by intravenous immunoglobulins Among the 8 patients with secondary immunodeficiency mean baseline serum globulin was 4 ± 1.6 g/L All strains were Omicron: the sub-variants were identified for 7/9 patients: 4 patients had BA.5 (22B) Omicron and 3 patients had XBB (22F) Omicron the sub-variants was not identifiable because of a too low viral load on the sample No patients required high flow oxygen or transfer to an intensive care unit 66% received a treatment for COVID-19 prior to IVIg including nirmatrelvir-ritonavir (2/9 Privigen®) was administered 3.5 weeks (median) after positive Sars-Cov-2 PCR without any corticosteroids or antiviral treatment 8 patients (including the patients treated for x-linked agammaglobulinemia) received a single dose of 1g/kg one patient received a lower dosage (0.4 g/kg) because of chronic kidney disease Oxygen therapy was discontinued 4.5 days after IVIg infusion for each patient The CRP significantly decreased 48 hours (34 ± 38 vs 72 mg ± 52 mg/L) and 7 to 10 days after IVIg injection (10 ± 12 mg/L Anti-spike IgG serology became positive for 6/8 patients (mean titer 2324 BAU The delay between infection and IVIg initiation as well as previous treatment before IVIg for Sars-Cov-2 infection had no influence on the response to IVIg Pulmonary function tests were available for 4 patients 3 months after IVIg: the forced vital capacity increased significantly for 2 patients (mean increase 425 mL (15%) while one patient remained stable (initially normal values) and one patient experienced alteration of her tests due to chronic graft rejection Figure 1 CT scan before (left) and after (right) intravenous immunoglobulin in immunocompromised patients with COVID-19 showing clear reduction in ground-glass opacities (arrows) One patient discontinued rituximab treatment because of the stability of his follicular lymphoma the immunosuppressive therapy was not modified One patient (#5) died 3 months after IVIg of a bacterial infection in a depressive geriatric background Immediate IVIg tolerance was good for all the patients: no patients experienced adverse events At the last follow-up visit (median 5 months 3 patients were still receiving immunoglobulin substitution: patient #2 received subcutaneous immunoglobulin whereas patient #7 and patient #9 received monthly IVIg Two patients (#2 and #3) experienced during the follow-up period a benign new Sars-Cov-2 infection (fever with no oxygen requirement) The other patients experienced no further sars-Cov-2 infection 1 woman; median age 63 years old) with no vaccine response (undetectable anti-spike antibodies despite 2 to 4 doses of vaccine) were treated by convalescent plasma therapy for COVID-19 Three patients received rituximab and various immunosuppressive drugs for autoimmune diseases (IgG4 related disease warm autoimmune hemolytic anemia and polyangiitis microscopic) and 3 patients received rituximab (n=2) or obinutuzumab for low grade lymphoma (mantle cell lymphoma follicular lymphoma and chronic lymphocytic leukemia) Only one patient required oxygen therapy before convalescent plasma infusion The Table 2 shows the main features of the two groups No difference were statistically significative in term of age BMI or comorbidity (high blood pressure or diabetes mellitus) Two patients treated with convalescent plasma experienced transient worsening after the infusion (fever and one patient required additional treatment with corticosteroids All patients finally recovered and experienced a favorable long term outcome The statistical analysis is hampered by the low size sample of both groups: we found a greater decrease of CRP 48 hours after IVIg than in plasma group but the difference did not reach statistical significance Table 2 Comparison of patients treated with IVIg or convalescent plasma for prolonged COVID-19 most studies of IVIg in COVID-19 have included critically-ill patients in intensive care units most of them requiring mechanical ventilation the current shortage of IVIg dictates an extremely rigorous selection of patients eligible for this treatment The raw data supporting the conclusions of this article will be made available by the authors The study was approved by local Ethics Committee (IRB00013412 The author(s) declare that no financial support was received for the research The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher Persistent SARS-coV-2 PCR positivity despite anti-viral treatment in immunodeficient patients Persistent SARS-CoV-2 infection in immunocompromised patients facilitates rapid viral evolution: Retrospective cohort study and literature review Recommendations on the use of COVID-19 convalescent plasma to treat immunocompromised patients CrossRef Full Text | Google Scholar COVID-19 convalescent plasma for the treatment of immunocompromised patients: A systematic review and meta-analysis doi: 10.1001/jamanetworkopen.2022.50647 Successful early treatment combining remdesivir with high-titer convalescent plasma among COVID-19-infected hematological patients Emerging RNA-dependent RNA polymerase mutation in a remdesivir-treated B-cell immunodeficient patient with protracted coronavirus disease 2019 Remdesivir-induced emergence of SARS-CoV2 variants in patients with prolonged infection Deployment of convalescent plasma for the prevention and treatment of COVID-19 COVID-19 convalescent plasma composition and immunological effects in severe patients Analysis of anti-SARS-CoV-2 Omicron-neutralizing antibody titers in different vaccinated and unvaccinated convalescent plasma sources IgM) in a general adult population and their relationship with alcohol consumption smoking and common metabolic abnormalities doi: 10.1111/j.1365-2249.2007.03545.x Commercial immunoglobulin products contain cross-reactive but not neutralizing antibodies against SARS-CoV-2 IgG response to spike protein of SARS-CoV-2 in healthy individuals and potential of intravenous IgG as treatment for COVID-19 Intravenous immunoglobulin contains high-titer neutralizing IgG antibodies to SARS-CoV-2 SARS-coV-2 antibody longitudinal profile of immune globulin preparations CrossRef Full Text | Google Scholar SARS-coV-2 neutralization in convalescent plasma and commercial lots of plasma-derived immunoglobulin Guidance on the use of convalescent plasma to treat immunocompromised patients with coronavirus disease 2019 Anti-SARS-CoV-2 antibodies in healthy donor plasma pools and IVIG products—an update Effect of regular intravenous immunoglobulin therapy on prognosis of severe pneumonia in patients with COVID-19 Clinical outcomes of intravenous immunoglobulin therapy in COVID-19 related acute respiratory distress syndrome: a retrospective cohort study The outcome of using intravenous immunoglobulin (IVIG) in critically ill COVID-19 patients’: a retrospective Intravenous immunoglobulins (IVIG) in severe/critical COVID-19 adult patients SARS-CoV-2 spike antibody concentration in gamma globulin products from high-prevalence COVID-19 countries are transmitted to X-linked agammaglobulinemia patients Polyclonal immunoglobulins for COVID-19 pre-exposure prophylaxis in immunocompromised patients Le Guenno G and Lobbes H (2024) Intravenous immunoglobulins for the treatment of prolonged COVID-19 in immunocompromised patients: a brief report Received: 11 March 2024; Accepted: 08 April 2024;Published: 19 April 2024 Copyright © 2024 Billi, Cholley, Grobost, Clément, Rieu, Le Guenno and Lobbes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) distribution or reproduction in other forums is permitted provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited in accordance with accepted academic practice distribution or reproduction is permitted which does not comply with these terms *Correspondence: Hervé Lobbes, aGxvYmJlc0BjaHUtY2xlcm1vbnRmZXJyYW5kLmZy Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher 94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish Rob Rinder is a barrister and TV personality  Rob Rinder Davka has been part of the driving spirit of Jewish people for millennia 3 min readAnybody who has listened to one of my lectures will know that I love Yiddish Yiddish words and phrases carry entire universes of meaning The sense can shift based on who’s speaking how long there is till lunch and whether there’s a gimmel in the month It’s said the Inuit have 50 words for snow… what does it say about Jews that Yiddish has twice that number of adjectives for the state of a person’s neurosis If anyone can explain the difference between meshugener and tsedreyter please get in touch but Yiddish reflects ideas that simply can’t be articulated in any other language the kid I represented couldn’t be more guilty Instead of wasting everyone’s time with a long speech in mitigation what I really wanted to say to the magistrates was I stood with Ben Helfgott at a gravesite outside Piotrków — there to consecrate the ground where his mother and sister had been murdered — when somebody beautifully recited a Yiddish poem like someone was plucking the strings of some internal spiritual violin And from all that infinite linguistic luxury it holds a dazzling multiplicity of meanings I spotted an older woman sitting at the back of the courtroom She looked like some magical blend of all my bubbe’s friends and was (and there’s no other word) farbissen Something had displeased her on some galactic level As if she’d just bitten into a rancid fishball (and I was the one who’d given it to her) she beckoned to me and uneasily I tiptoed over “you can do UJIA but you can’t do WIZO?” It’s davka to the core: they tell me he can’t do our talk You see it in the Torah where Jews carve out their astonishing an ongoing negotiation where repeatedly we turn back to Him and say What other religion doesn’t just accept on faith alone but begins this sort of discussion with the divine It doesn’t always go well — there’s a fair amount of correction on the path — but it’s been part of the driving spirit of Jewish people for millennia I’ve worked alongside survivors of the Shoah and other genocides and always see it shining from them The world decided that they were done for… yet In the face of so many working for our destruction they wouldn’t accept the state of play and instead pushed back held their own against a narrative others tried to write on their behalf It’s the lesson about the Jewish people that I most like to take into the world (and what a joy that I need to use Yiddish to do it) “stand on one leg and tell me everything about Judaism” I’d skip the Hillel “do unto others” stuff (I hope they’d know that anyway) Because we’re still a people despite every attempt to extinguish us and what better summation of our spirit can there be if you disagree with me I couldn’t be happier Rob Rinder Davka You do not have access to www.researchgate.net The site owner may have set restrictions that prevent you from accessing the site The heated debate over the pros and cons of contrast-enhanced mammography and MRI for screening women with dense breast tissue has resurfaced in the Netherlands A new vote on the use of MRI as a screening tool is due to take place in parliament this week women participating in the Dutch screening program are not informed about their tissue density and no additional MRI is officially performed during screening While the government is now focusing on the potential of contrast-enhanced mammography for screening dense breast tissue the Dutch Radiology Society (NVvR) and many imaging experts support immediate access to MRI for these patients The Dutch Health Council (Gezondheidsraad) decided against implementation of breast MRI screening, and it suggested that contrast-enhanced mammography should be explored as a potential alternative through a new trial. The NVvR rejected the guidance in a statement released on 2 December a member of the Ministry of Health subcommittee last week seemingly undermined the official recommendations of the Health Secretary by proposing that women with dense breast tissue undergo MRI for screening and be told about their breast density A vote on the matter is scheduled for this week there are mixed feelings on the long-term role of both MRI and contrast-enhanced mammography in screening implementation of MRI screening will have some challenges," Dr. Marc Lobbes a breast radiologist at the Zuyderland Medical Center and the Maastricht University Medical Center in the Netherlands He lists the main challenges as the following: which showed that by adding breast MRI after a recent negative screening mammogram in women with extremely dense breast tissue the interval cancer rate could drop significantly He believes that contrast-enhanced mammography has "untapped potential for screening purposes" because it is equal in sensitivity to MRI sensitivity is fairly equal between contrast-enhanced mammography and MRI and contrast-enhanced mammography's specificity might even be slightly better meaning that it has fewer false positives than MRI," said Lobbes who is an advisor to the Dutch Health Council on contrast-enhanced mammography Contrast-enhanced mammography is much easier to implement Four vendors now offer five commercial units systems can often be upgraded rather than fully replaced Disadvantages are the use of iodine contrast agents and the use of radiation which is 50% to 80% higher than mammography but still within acceptable limits for breast screening "The council is not fully convinced that MRI screening for extreme dense breast tissue is a robust solution for the future They want to avoid investing in expensive hardware that might be obsolete in the next 5 to 10 years and so are recommending a comparative study of CEM and MRI," Lobbes said noninferiority study recommended by the Council will need to be accepted onto the research agenda priority list of large funding bodies "Although I understand the council's conclusion and support a rapid start of such a prospective trial as a doctor I also feel disappointment that no alternative was offered to women in the transition period," Lobbes added He pointed to plans underway for several large prospective trials that aim to study the advantages and disadvantages of contrast-enhanced mammography and MRI in the screening setting with the aim of creating a more individualized screening strategy that leverages contrast-enhanced mammography The NVvR claims that the possible advantages of contrast-enhanced mammography have been overstated Given the demonstrated efficacy of MRI in the DENSE trial the NVvR believes that it should be implemented as soon as possible and not be delayed by the extensive research needed to assess the potential of contrast-enhanced mammography contrast-enhanced mammography will not improve on the sensitivity of breast MRI (and likely will be a bit worse)," Dr. Ritse Mann "While potentially a reduction of false-positive findings is possible this has never been tested in a real screening setting where the focus is on detection of small and subtle lesions," added Mann who is a breast radiologist at Radboud University Medical in Nijmegen and the Netherlands Cancer Institute and also chair of the scientific committee of the European Society of Breast Imaging There are also queries over the Health Secretary's statement that evaluating contrast-enhanced mammography and subsequent implementation will take a similar time as implementing breast MRI screening at this point in time "While we do not disagree that evaluation of the potential of contrast-enhanced mammography in screening should be performed we disagree that this is feasible within a very short period," noted Dr. Jeroen Veltman breast radiologist at Hospital Group Twente (Ziekenhuisgroep Twente ZGT) Almelo and chair of the breast section of the NVvR and this investigation is likely to take a similar amount of time "The Dutch breast section strongly believes it is unethical not to offer MRI to women with extremely dense breasts who would like to undergo the examination," he said "The current advice of the Secretary leaves women without any possibility of undergoing proven better screening for years to come." Contrast-enhanced spectral mammography (CESM) is gaining momentum the technique will be a part of the workup for breast imaging in the future not least because CESM rivals breast MRI in many ways according to European breast imaging specialists or contrast-enhanced dual-energy mammography (CEDM) is a mammographic technique in which an iodine-based contrast agent is administered intravenously two minutes prior to image acquisition an iodine contrast concentration higher than 300 mg/mL is used The patient is positioned in the mammography unit like a regular full-field digital mammography (FFDM) examination with image acquisition consisting of two views per breast: mediolateral oblique and craniocaudal but it also acquires a high-energy image to visualize iodine uptake CESM is generally used in diagnostic settings with clinical indications similar to breast MRI while both CESM and MRI are based on analysis of wash-in and wash-out of breast lesions several technical differences may influence clinical performance and images interpretation from the imaging department at Lausanne University Hospital in Switzerland The major differences include 2D versus 3D images acquisition under compression versus free of compression CESM matches the performance of breast MRI not only in terms of breast cancer detection but also in the assessment of disease extent from the radiology department at Maastricht University Medical Center in the Netherlands prospective multicenter study conducted wi 178 patients found overall sensitivity of MRI was better than CESM (76% versus 72%) but overall specificity of CESM was better than MRI (94% versus 88%) CESM has fewer false positives than breast MRI "I think it is the combination between your mammographic image (in which you can appreciate the morphology of lesions very well through the high spatial resolution) and the enhancement seen on the recombined images," he told ECR Today it is much more difficult to appreciate the subtle morphology." it is already a regular part of the breast workup at Maastricht University Medical Centre and has been since the device's introduction Radiologists primarily use CESM for recalls from screening but also as a breast MRI alternative for instance in preoperative staging or response monitoring in breast cancer patients undergoing neoadjuvant chemotherapy They also use it for unknown primary tumor screening or with highly suspicious findings on a physical exam by the surgeon and don't expect it to replace mammography screening anytime soon "I think regular mammography is still a very good basic exam," he said "The proper indications for CESM still need to be figured out in studies and there are even studies that evaluate whether it could be used for high-risk screening but I still regard CESM as a sort of 'second-line' mammography study The use of iodinated contrast agent with potential side effects and the slightly increased radiation dose prevent it from being used in But we will learn about the indications in the upcoming years Another area of future interest is whether CESM can replace breast MRI for certain indications Other questions include whether CESM can be optimized and if the imaging protocol may be optimized Different timing protocols exist for CT for different indications "The current protocol is rather robust and works fine but maybe there is room for squeezing out more details in specialized CESM protocols," Lobbes pointed out Joining Dromain and Lobbes at Saturday's session is Dr. Eva Fallenberg from the clinical radiology department at Universitätsmedizin Charité Berlin in Berlin She will outline the current indications for clinical implementation of CESM and how the modality can be a problem-solver She will also familiarize attendees with results of published studies on overall performance of CESM compared with digital mammography Dromain will discuss the performance of CESM compared with breast MRI regarding lesion morphology and enhancement Originally published in ECR Today on 3 March 2018 Copyright © 2018 European Society of Radiology enjoys a 'Secret Life' on Channel 4","image":"https://api.thejc.atexcloud.io/image-service/view/acePublic/alias/contentid/173ltwp4jmvmrmd6h2c/0/channel-4-kid-jpg.webp","url":"https://www.thejc.com/news/community/nathaniel-5-enjoys-a-secret-life-on-channel-4-s6gwpkvu","description":"Chigwell boy is star of prime-time show","publisher":{"@context":"https://schema.org","@type":"NewsMediaOrganization","name":"The Jewish Chronicle","url":"https://www.thejc.com","description":"Founded in 1841 Rosa Doherty is social affairs correspondent for the Jewish Chronicle enjoys a 'Secret Life' on Channel 4Chigwell boy is star of prime-time show Rosa Doherty 1 min readEssex couple Victoria and Howard always wondered how their five-year-old son Nathaniel behaved when they were not around They know now as Nathaniel is one of the stars of Channel 4 documentary series The Secret Life of 5 Year Olds “He is such a lobbes and scallywag so we thought sending him on the show would be a great way to find out what he got up to,” said his proud mum “We didn’t tell him what he was doing when we went to the audition He thought we were just going for a play date “A few weeks later we got the call to say he had been selected “What parent doesn’t want to see their child on television?” Victoria said “We thought it would be a great memento for the family and some harmless fun Every time I’ve seen an advert for the show “I have had messages from teachers [at his Jewish school] and all his friends are excited.” Nathaniel declares that "if you don’t share God will get angry and Theresa May will get angry" “He talks about God a lot which makes me laugh,” Victoria said He asks about the government and the Queen too.” The Secret Life of Five Year Olds is on Channel 4 - next episode on May 15 at 8pm Work to demolish a house owned by the serial killer Marc Dutroux has got under way in the Hainaut village of Sars-la-Buissière Work to demolish the house has started more than 26 years after the bodies of Julie Lejeune and Mélissa Russo (both 8 years old) were found in its garden told the Francophone public broadcaster RTBF that “After talks with Julie and Mélissa’s parents we have started demolition work We want to provide the site with the serenity that it merits” The house in Sars-la-Buissière is one of the houses that Marc Dutroux used as a base to carry out a catalogue of crime that shocked Belgium and the world in the 1990’s After talks with the families of Mélissa Russo and Julie Lejeune it has been decided that no memorial plaque will be placed at the site once demolition work on the house has been completed labourers started work to empty the house and get it ready for demolition One the demolition work has been completed a lawn will be laid at the site The Francophone socialist Mayor of Lobbes Lucien Baudin told journalists "After more than 25 years the wish of many is being granted and the house is being demolished It is the end of a sad and difficult chapiter for our region” Another house owned by Marc Dutroux in the Marcinelle district of Charleroi (Hainaut) was demolished last year There a memorial garden will be laid to remember the serial killers’ victims Marc Dutroux shocked Belgium in the 1990’s with the kidnap false imprisonment and rape of 5 girls and 1 young woman: Julie Lejeune (8) Sabine Dardenne (12) and Laetitia Delhez (14) Only Laetitia Delhez and Sabine Dardenne were rescued alive Marc Dutroux was sentenced to life imprisonment in 2004 Your guide to London's culture and transport news and events taking place across the city Published on 14th August 2023 by ianVisits in London's Alleys and Passages This is a dank dirty passage that slips in between the London Underground’s former head office and a posh hotel you’re going to expect something religious going on the origins of the name seem potentially more myth than fact It’s generally said that this patch of London was the site of a 12th-century chapel originally built by Henry II in thanks for an Irish monk’s prayers which he believed saved him and his fleet from a stormy death off the French coast Except – there isn’t any record of an Irish monk being canonised as St Ermin who may have been associated with a Norman knight who accompanied William the Conquerer when he came to England But it’s pushing it a bit to suggest that after years of seeming nothing happening that King Henry II would suddenly dedicate a chapel to the monk A newspaper suggested in 1901 that the origins could be a corruption of St Hermit’s Hill and while the alley isn’t exactly hilly it’s in the very flat Thorney Island part of Westminster and a modest bulge in the ground would have been a hill as far as locals were concerned The other difficulty is that the alleyway hasn’t always been called St Ermins The alley first shows up as a longer forked passage in William Morgan’s map of London from 1682 and much less appealingly as Torment Hill in John Roque’s map of 1746 a small branch off the alley is showing up as St Ermins Hill in the R Horwood map but it’s not clear if that was being applied to the whole alley but it’s certainly applied to the whole alley in the Greenwood map of 1828 It’s possible that the name was corrupted from something else or just plain invented in the late 1700s by some romantic fellow who might have known about a Belgian saint Today it’s not a particularly holy alley being really not much more than a goods access to the two large buildings on either side The south side of the alley is dominated by St Ermin’s Hotel This was originally built as serviced residential flats in 1887-89 but just a few years after it was built it was converted into a hotel and was to later become famous as much for its luxury as for its spies and political plots Although the front of the hotel is a grand Queen Anne style building providing mainly doorways for staff to use to come outside for a smoke The other side is more famous for what it looks like on the other side, being 55 Broadway more famously the art-deco headquarters of the London Underground It’s not that you’ll find much of the art deco down here either as it’s mainly some blanked-off windows and a long row of ventilation grills. and if you carry on down the alley to the end where it curves round then you can get a good look at some bins and a fire escape Updated 14th Aug 8:50am – corrected which century Henry II lived in This website has been running now for over a decade, and while advertising revenue contributes to funding the website, it doesn't cover the costs. That is why I have set up a facility with DonorBox where you can contribute to the costs of the website and time invested in writing and research for the news articles It's very similar to the way The Guardian and many smaller websites are now seeking to generate an income in the face of rising costs and declining advertising Whether it's a one-off donation or a regular giver every additional support goes a long way to covering the running costs of this website and keeping you regularly topped up doses of Londony news and facts If you like what you read on here, then please support the website here Another possible source is the Welsh Saint Armel who is commemorated in the nearby Abbey without any obvious reason,AKA as St Vermin’s by many in 55 Broadway and the latest news published on ianVisits You can unsubscribe at any time from my weekly emails © ianVisits Woodville-West Torrens defeated Port Adelaide to take the points in Round 5 of SANFL action Port Adelaide have been defeated by the Western Bulldogs in Round 8 Chad Cornes spoke to portadelaidefc.com.au ahead of Round 8's clash against the Bulldogs Power fans used the #PAHPcelebration hashtag on Instagram to share them cheering the great moments of Port's close win over the Suns Connor Rozee and Jordan Dawson speak to the media at Adelaide Oval ahead of Showdown LVII Watch Port Adelaide’s press conference after Round 8's match against Western Bulldogs Port Adelaide has made four changes for Saturday’s clash against Woodville-West Torrens The Port Adelaide Football Club acknowledges the land on which we train and play are based on the traditional lands of the Kaurna people We respect their spiritual relationship with their country We also acknowledge Aboriginal and Torres Strait Islander people as the traditional custodians of Australia and that their cultural and heritage beliefs are still as important to the living people today