Comparison of the diagnostic accuracy between radial and conventional meander-like breast ultrasound in a clinical setting

Introduction Radial ultrasound (r-US) or ductosonography is usually applied as an adjunct to meander-like ultrasound (m-US) but rarely as the sole scanning method. Here we compare r-US and m-US with regard to breast lesions detected and interpreted as BI-RADS 3 , i.e. probably benign. Materials and Methods Eligible patients received a meander-like and a radial breast ultrasound in random order on the same day by two different examiners. The same type of ultrasound equipment was used but with specific probes. Results We performed 1984 dual ultrasound examinations. In 121 BI-RADS 3 lesions, a breast biopsy was performed and the histology of two (1.7%) BI-RADS 3 lesions turned out to be malignant. The specificity for m-US was 95.0%, and 96.6% for r-US. One (0.8%) benign lesion was missed by m-US, whereas r-US missed 2 (1.7%) benign lesions. Each missed lesion was identified by the other scanning method. The mean maximal lesion diameter (ICC 0.82), the mean lesion volume (ICC 0.87), the clock-face localization (κ 0.82) and the mean distance to the skin (ICC 0.77) show excellent, and the mean distance from the lesion to the mammilla (ICC 0.65) good agreement between m-US and r-US. The agreement between m-US and r-US in regard to sonomorphologic criteria ranged from excellent to poor. In 71.9% the lesion was classified as BI-RADS 3 by m-US as well as r-US. The examination time for r-US was significantly shorter than for m-US. Conclusion For BI-RADS 3 breast lesions, radial breast ultrasound is an alternative to meander-like ultrasound since the diagnostic accuracy of the two scanning methods is comparable. Notably, patients benefit from a significantly shorter examination time.

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Clinical Diagnostic Accuracy of Onychomycosis: A Multispecialty Comparison Study

Dermatology Research and Practice ◽

10.1155/2018/2630176 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

David G. Li ◽

Jeffrey M. Cohen ◽

Anar Mikailov ◽

Ramone F. Williams ◽

Alvaro C. Laga ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Clinical Diagnosis ◽

Clinical Setting ◽

Systemic Treatment ◽

Periodic Acid ◽

Comparison Study ◽

Periodic Acid Schiff ◽

Clinical Diagnostic ◽

Prospective Investigation

Although onychomycosis can be diagnosed clinically, many guidelines still recommend pathologic confirmation of the diagnosis prior to initiation of systemic treatment. We retrospectively reviewed results from 541 toenail clippings (160 by dermatologists, 198 by podiatrists, and 183 by other provider types) sent to the Brigham and Women’s Department of Dermatopathology between January 2000 and December 2013 for confirmatory periodic acid-Schiff (PAS) testing of clinically diagnosed onychomycosis. Of these, 93 (58.1%), 125 (63.1%), and 71 (38.8%) were sent for confirmation of onychomycosis (as opposed to diagnosis of onychodystrophy) by dermatologists, podiatrists, and other provider types, respectively. Confirmatory PAS stains were positive in 70 (75.3%), 101 (80.8%), and 47 (66.2%) of samples ordered by dermatologists, podiatrists, and other providers, respectively. Our study demonstrates that clinical diagnosis of onychomycosis in the appropriate clinical setting is accurate across specialties. Further prospective investigation on the accuracy of clinical diagnosis of onychomycosis may be beneficial.

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