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3. Low-dose CT screening among never-smokers with or without a family history of lung cancer in Taiwan: a prospective cohort study

Author

Chan, Chang-Chuan, Chan, Si-Wa, Chang, I-Shou, Chang, Jer-Hwa, Chao, Kun-San, Chen, Chi-Jen, Chen, Huei-Wen, Chiang, Chun-Ju, Chiou, Hung-Yi, Chou, Mei-Chun, Chung, Chi-Li, Chung, Ta-Jung, Guo, Yue Leon, Hsiao, Chin-Fu, Huang, Chien-Sheng, Ko, Sheung-Fat, Lee, Mei-Hsuan, Li, Yao-Jen, Liao, Yu-San, Lu, Yueh-Hsun, Ou, Hsin-You, Wu, Ping-An, Yang, Hwai-I, Yang, Shi-Yi, Yang, Szu-Chun, Chang, Gee-Chen, Chiu, Chao-Hua, Yu, Chong-Jen, Chang, Yeun-Chung, Chang, Ya-Hsuan, Hsu, Kuo-Hsuan, Wu, Yu-Chung, Chen, Chih-Yi, Hsu, Hsian-He, Wu, Ming-Ting, Yang, Cheng-Ta, Chong, Inn-Wen, Lin, Yu-Ching, Hsia, Te-Chun, Lin, Meng-Chih, Su, Wu-Chou, Lin, Chih-Bin, Lee, Kang-Yun, Wei, Yu-Feng, Lan, Gong-Yau, Chan, Wing P, Wang, Kao-Lun, Wu, Mei-Han, Tsai, Hao-Hung, Chian, Chih-Feng, Lai, Ruay-Sheng, Shih, Jin-Yuan, Wang, Chi-Liang, Hsu, Jui-Sheng, Chen, Kun-Chieh, Chen, Chun-Ku, Hsia, Jiun-Yi, Peng, Chung-Kan, Tang, En-Kuei, Hsu, Chia-Lin, Chou, Teh-Ying, Shen, Wei-Chih, Tsai, Ying-Huang, Tsai, Chun-Ming, Chen, Yuh-Min, Lee, Yu-Chin, Chen, Hsuan-Yu, Yu, Sung-Liang, Chen, Chien-Jen, Wan, Yung-Liang, Hsiung, Chao Agnes, and Yang, Pan-Chyr

Published
2024
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4. Consensus survey on pre-procedural safety practices in radiological examinations: a multicenter study in seven Asian regions.

Author

Lee, Yuan-Hao, Quek, Swee, Khong, Pek-Lan, Lee, Cindy, Wu, Jim, Zhang, Lei, Ng, Kwan-Hoong, Yang, Seoung-Oh, Kudo, Kohsuke, Do, Kyung-Hyun, Kim, Seung, Cheng, Amy, Leung, Joseph, Chang, Yeun-Chung, Hsu, Hsian-He, Chan, Wing, and Chen, Dillon

Subjects
Asia, China, Consensus, Health Care Surveys, Humans, Internship and Residency, Japan, Magnetic Resonance Imaging, Malaysia, Patient Safety, Positron-Emission Tomography, Quality of Health Care, Radiography, Radiology, Republic of Korea, Safety Management, Singapore, Taiwan, Tomography, X-Ray Computed
Abstract

OBJECTIVE: To understand the status of pre-procedural safety practices in radiological examinations at radiology residency training institutions in various Asian regions. METHODS: A questionnaire based on the Joint Commission International Accreditation Standards was electronically sent to 3 institutions each in 10 geographical regions across 9 Asian countries. Questions addressing 45 practices were divided into 3 categories. A five-tier scale with numerical scores was used to evaluate safety practices in each institution. Responses obtained from three institutions in the United States were used to validate the execution rate of each surveyed safety practice. RESULTS: The institutional response rate was 70.0% (7 Asian regions, 21 institutions). 44 practices (all those surveyed except for the application of wrist tags for identifying patients with fall risks) were validated using the US participants. Overall, the Asian participants reached a consensus on 89% of the safety practices. Comparatively, most Asian participants did not routinely perform three pre-procedural practices in the examination appropriateness topic. CONCLUSION: Based on the responses from 21 participating Asian institutions, most routinely perform standard practices during radiological examinations except when it comes to examination appropriateness. This study can provide direction for safety policymakers scrutinizing and improving regional standards of care. ADVANCES IN KNOWLEDGE: This is the first multicenter survey study to elucidate pre-procedural safety practices in radiological examinations in seven Asian regions.

Published
2020

7. Low-dose CT screening among never-smokers with or without a family history of lung cancer in Taiwan: a prospective cohort study

Author

Chang, Gee-Chen, primary, Chiu, Chao-Hua, additional, Yu, Chong-Jen, additional, Chang, Yeun-Chung, additional, Chang, Ya-Hsuan, additional, Hsu, Kuo-Hsuan, additional, Wu, Yu-Chung, additional, Chen, Chih-Yi, additional, Hsu, Hsian-He, additional, Wu, Ming-Ting, additional, Yang, Cheng-Ta, additional, Chong, Inn-Wen, additional, Lin, Yu-Ching, additional, Hsia, Te-Chun, additional, Lin, Meng-Chih, additional, Su, Wu-Chou, additional, Lin, Chih-Bin, additional, Lee, Kang-Yun, additional, Wei, Yu-Feng, additional, Lan, Gong-Yau, additional, Chan, Wing P, additional, Wang, Kao-Lun, additional, Wu, Mei-Han, additional, Tsai, Hao-Hung, additional, Chian, Chih-Feng, additional, Lai, Ruay-Sheng, additional, Shih, Jin-Yuan, additional, Wang, Chi-Liang, additional, Hsu, Jui-Sheng, additional, Chen, Kun-Chieh, additional, Chen, Chun-Ku, additional, Hsia, Jiun-Yi, additional, Peng, Chung-Kan, additional, Tang, En-Kuei, additional, Hsu, Chia-Lin, additional, Chou, Teh-Ying, additional, Shen, Wei-Chih, additional, Tsai, Ying-Huang, additional, Tsai, Chun-Ming, additional, Chen, Yuh-Min, additional, Lee, Yu-Chin, additional, Chen, Hsuan-Yu, additional, Yu, Sung-Liang, additional, Chen, Chien-Jen, additional, Wan, Yung-Liang, additional, Hsiung, Chao Agnes, additional, Yang, Pan-Chyr, additional, Chan, Chang-Chuan, additional, Chan, Si-Wa, additional, Chang, I-Shou, additional, Chang, Jer-Hwa, additional, Chao, Kun-San, additional, Chen, Chi-Jen, additional, Chen, Huei-Wen, additional, Chiang, Chun-Ju, additional, Chiou, Hung-Yi, additional, Chou, Mei-Chun, additional, Chung, Chi-Li, additional, Chung, Ta-Jung, additional, Guo, Yue Leon, additional, Hsiao, Chin-Fu, additional, Huang, Chien-Sheng, additional, Ko, Sheung-Fat, additional, Lee, Mei-Hsuan, additional, Li, Yao-Jen, additional, Liao, Yu-San, additional, Lu, Yueh-Hsun, additional, Ou, Hsin-You, additional, Wu, Ping-An, additional, Yang, Hwai-I, additional, Yang, Shi-Yi, additional, and Yang, Szu-Chun, additional

Published
2023
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11. Low-dose CT screening among never-smokers with or without a family history of lung cancer in Taiwan: a prospective cohort study.

Author

Chang, Gee-Chen, Chiu, Chao-Hua, Yu, Chong-Jen, Chang, Yeun-Chung, Chang, Ya-Hsuan, Hsu, Kuo-Hsuan, Wu, Yu-Chung, Chen, Chih-Yi, Hsu, Hsian-He, Wu, Ming-Ting, Yang, Cheng-Ta, Chong, Inn-Wen, Lin, Yu-Ching, Hsia, Te-Chun, Lin, Meng-Chih, Su, Wu-Chou, Lin, Chih-Bin, Lee, Kang-Yun, Wei, Yu-Feng, and Lan, Gong-Yau

Subjects
FAMILY history (Medicine), MEDICAL screening, LUNG cancer, TUBERCULOSIS, PASSIVE smoking, VIRTUAL colonoscopy, ARTIFICIAL respiration
Abstract

In Taiwan, lung cancers occur predominantly in never-smokers, of whom nearly 60% have stage IV disease at diagnosis. We aimed to assess the efficacy of low-dose CT (LDCT) screening among never-smokers, who had other risk factors for lung cancer. The Taiwan Lung Cancer Screening in Never-Smoker Trial (TALENT) was a nationwide, multicentre, prospective cohort study done at 17 tertiary medical centres in Taiwan. Eligible individuals had negative chest radiography, were aged 55–75 years, had never smoked or had smoked fewer than 10 pack-years and stopped smoking for more than 15 years (self-report), and had one of the following risk factors: a family history of lung cancer; passive smoke exposure; a history of pulmonary tuberculosis or chronic obstructive pulmonary disorders; a cooking index of 110 or higher; or cooking without using ventilation. Eligible participants underwent LDCT at baseline, then annually for 2 years, and then every 2 years up to 6 years thereafter, with follow-up assessments at each LDCT scan (ie, total follow-up of 8 years). A positive scan was defined as a solid or part-solid nodule larger than 6 mm in mean diameter or a pure ground-glass nodule larger than 5 mm in mean diameter. Lung cancer was diagnosed through invasive procedures, such as image-guided aspiration or biopsy or surgery. Here, we report the results of 1-year follow-up after LDCT screening at baseline. The primary outcome was lung cancer detection rate. The p value for detection rates was estimated by the χ2 test. Univariate and multivariable logistic regression analyses were used to assess the association between lung cancer incidence and each risk factor. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of LDCT screening were also assessed. This study is registered with ClinicalTrials.gov , NCT02611570 , and is ongoing. Between Dec 1, 2015, and July 31, 2019, 12 011 participants (8868 females) were enrolled, of whom 6009 had a family history of lung cancer. Among 12 011 LDCT scans done at baseline, 2094 (17·4%) were positive. Lung cancer was diagnosed in 318 (2·6%) of 12 011 participants (257 [2·1%] participants had invasive lung cancer and 61 [0·5%] had adenocarcinomas in situ). 317 of 318 participants had adenocarcinoma and 246 (77·4%) of 318 had stage I disease. The prevalence of invasive lung cancer was higher among participants with a family history of lung cancer (161 [2·7%] of 6009 participants) than in those without (96 [1·6%] of 6002 participants). In participants with a family history of lung cancer, the detection rate of invasive lung cancer increased significantly with age, whereas the detection rate of adenocarcinoma in situ remained stable. In multivariable analysis, female sex, a family history of lung cancer, and age older than 60 years were associated with an increased risk of lung cancer and invasive lung cancer; passive smoke exposure, cumulative exposure to cooking, cooking without ventilation, and a previous history of chronic lung diseases were not associated with lung cancer, even after stratification by family history of lung cancer. In participants with a family history of lung cancer, the higher the number of first-degree relatives affected, the higher the risk of lung cancer; participants whose mother or sibling had lung cancer were also at an increased risk. A positive LDCT scan had 92·1% sensitivity, 84·6% specificity, a PPV of 14·0%, and a NPV of 99·7% for lung cancer diagnosis. TALENT had a high invasive lung cancer detection rate at 1 year after baseline LDCT scan. Overdiagnosis could have occurred, especially in participants diagnosed with adenocarcinoma in situ. In individuals who do not smoke, our findings suggest that a family history of lung cancer among first-degree relatives significantly increases the risk of lung cancer as well as the rate of invasive lung cancer with increasing age. Further research on risk factors for lung cancer in this population is needed, particularly for those without a family history of lung cancer. Ministry of Health and Welfare of Taiwan. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Artificial Intelligence-Assisted Pulmonary Nodule Detection Improves Accuracy and Efficiency in Lung Cancer Screening

Author

Chang, Yeun-Chung, primary, Chen, Hsin-Ming, additional, Lo, Yi-Ping, additional, Chen, Hui-Mei, additional, Lian, Ciou Fang, additional, Lin, Feng-Mao, additional, Chen, Shyh-Jye, additional, Chen, Wing P., additional, Hsu, Hsian-He, additional, Yu, Chong-Jen, additional, Chen, Chi-Wen, additional, Huang, Wei-Da, additional, and Yang, Pan-Chyr, additional

Published
2022
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31. Transcatheter Arterial Chemoembolization with Drug-Eluting Beads for the Treatment of Hepatocellular Carcinoma: Recommended Selection for Small-Caliber (<100 μm) Beads

Author

Chang,Wei-Chou, Hsu,Hsian-He, Chiu,Sung-Hua, Huang,Wen-Yen, Lo,Cheng-Hsiang, Lin,Hsuan-Hwai, Huang,Pei-Ching, Shih,Yu-Lueng, and Wan,Yung-Liang

Subjects
Journal of Hepatocellular Carcinoma
Abstract

Wei-Chou Chang,1 Hsian-He Hsu,1 Sung-Hua Chiu,1 Wen-Yen Huang,2 Cheng-Hsiang Lo,2 Hsuan-Hwai Lin,3 Pei-Ching Huang,4 Yu-Lueng Shih,3 Yung-Liang Wan4 1Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan; 2Department of Radiation Oncology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan; 3Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan; 4Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, TaiwanCorrespondence: Yung-Liang WanDepartment of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, TaiwanEmail ylw0518@cgmh.org.twAbstract: Drug-eluting beads transarterial chemoembolization (DEB-TACE) is an alternative to conventional lipiodol-based TACE (cTACE) to treat hepatocellular carcinoma (HCC). With the advancement in pharmacology, small-caliber DEB-TACE (< 100 μm) has been introduced since 2016. For the treatment of hepatic neoplasms or HCC, there is a tendency to use smaller beads by DEB-TACE to achieve more extensive tumor necrosis and a significant reduction in liver toxicity in comparison with that caused by cTACE. However, the indications and potential complications of small-caliber DEB-TACE remain uncertain and have not been well established, due to lack of randomized phase III clinical trials. Instead of systematic or meta-analysis review, this narrative review article describes the suggested indications and contraindications of DEB-TACE with small DEBs, benefit of super-selective embolization of the feeding arteries and the recommended selection of small-caliber DEB. This review was approved by the institutional review board (File Number: 1-105-05-158).Keywords: chemoembolization, HCC, TACE, DEB-TACE, liver, review

Published
2021

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