Increased incidence trend of low-grade and high-grade neuroendocrine neoplasms

Purpose: The incidence of neuroendocrine neoplasms is increasing. This work aimed at: (i) establishing worldwide incidence trend of low-grade neuroendocrine neoplasms; (ii) defining the incidence and temporal trend of high-grade neuroendocrine neoplasms in USA utilizing the Surveillance Epidemiology and End Results database; (iii) comparing trends for low-grade vs. high-grade neuroendocrine neoplasms. Methods: We conducted a literature search on MEDLINE and Scopus databases and incidence trends were plotted for 1973-2012. The Surveillance Epidemiology and End Results database was used to identify incidence rates in USA for 1973-2012. Incidence rates were stratified according to histological grade, gender and ethnicity. Trends were summarized as annual percent change and corresponding 95% confidence interval. Results: 11 studies were identified involving 72,048 cases; neuroendocrine neoplasm incidence rates increased over time in all countries for all sites, except for appendix. In Surveillance Epidemiology and End Results low-grade neuroendocrine neoplasm incidence rate increased from 1.09 in 1973 to 3.51 per 100,000 in 2012. During this interval, high-grade neuroendocrine neoplasm incidence rate increased from 2.54 to 10.52 per 100,000. African Americans had the highest rates of digestive neuroendocrine neoplasms with male prevalence in high-grade. Conclusions: Our data indicate an increase in the incidence of neuroendocrine neoplasms as a worldwide phenomenon, affecting most anatomical sites and involving both low-grade and high-grade neoplasms. © 2017, The Author(s)

Variation in quantitative CT air trapping in heavy smokers on repeat CT examinations

Item does not contain fulltextOBJECTIVES: To determine the variation in quantitative computed tomography (CT) measures of air trapping in low-dose chest CTs of heavy smokers. METHODS: We analysed 45 subjects from a lung cancer screening trial, examined by CT twice within 3�months. Inspiratory and expiratory low-dose CT was obtained using breath hold instructions. CT air trapping was defined as the percentage of voxels in expiratory CT with an attenuation below -856�HU (EXP(-856)) and the expiratory to inspiratory ratio of mean lung density (E/I-ratio(MLD)). Variation was determined using limits of agreement, defined as 1.96 times the standard deviation of the mean difference. The effect of both lung volume correction and breath hold reproducibility was determined. RESULTS: The limits of agreement for uncorrected CT air trapping measurements were -15.0 to 11.7�\% (EXP(-856)) and -9.8 to 8.0�\% (E/I-ratio(MLD)). Good breath hold reproducibility significantly narrowed the limits for EXP(-856) (-10.7 to 7.5�\%, P?=?0.002), but not for E/I-ratio(MLD) (-9.2 to 7.9�\%, P?=?0.75). Statistical lung volume correction did not improve the limits for EXP(-856) (-12.5 to 8.8�\%, P?=?0.12) and E/I-ratio(MLD) (-7.5 to 5.8�\%, P?=?0.17). CONCLUSIONS: Quantitative air trapping measures on low-dose CT of heavy smokers show considerable variation on repeat CT examinations, regardless of lung volume correction or reproducible breath holds. KEY POINTS: � Computed tomography quantitatively measures small airways disease in heavy smokers. � Measurements of air trapping vary considerably on repeat CT examinations. � Variation remains substantial even with reproducible breath holds and lung volume correction