446 DETECTION OF SUBCHONDRAL CYSTS IN THE KNEE: DIAGNOSTIC PERFORMANCE OF VOLUMERADTM DIGITAL TOMOSYNTHESIS COMPARED WITH CONVENTIONAL RADIOGRAPHY USING MRI AS THE REFERENCE STANDARD

Purpose/Objectives: To compare the diagnostic performance of dual-energy subtraction (DE) and conventional radiography (CR) for detecting pulmonary emphysema using computed tomography (CT) as a reference standard. Methods and Materials: Sixty-six patients (24 female, median age 73) were retrospectively included after obtaining lateral and posteroanterior chest X-rays with a dual-shot DE technique and chest CT within ±3 months. Two experienced radiologists first evaluated the standard CR images and, second, the bone-/soft tissue weighted DE images for the presence (yes/no), degree (1–4), and quadrant-based distribution of emphysema. CT was used as a reference standard. Inter-reader agreement was calculated. Sensitivity and specificity for the correct detection and localization of emphysema was calculated. Further degree of emphysema on CR and DE was correlated with results from CT. A p-value < 0.05 was considered as statistically significant. Results: The mean interreader agreement was substantial for CR and moderate for DE (kCR = 0.611 vs. kDE = 0.433; respectively). Sensitivity, as well as specificity for the detection of emphysema, was comparable between CR and DE (sensitivityCR 96% and specificityCR 75% vs. sensitivityDE 91% and specificityDE 83%; p = 0.157). Similarly, there was no significant difference in the sensitivity or specificity for emphysema localization between CR and DE (sensitivityCR 50% and specificityCR 100% vs. sensitivityDE 57% and specificityDE 100%; p = 0.157). There was a slightly better correlation with CT of emphysema grading in DE compared to CR (rDE = 0.75 vs. rCR = 0.68; p = 0.108); these differences were not statistically significant, however. Conclusion: Diagnostic accuracy for the detection, quantification, and localization of emphysema between CR and DE is comparable. Interreader agreement, however, is better with CR compared to DE

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Digital Tomosynthesis in the Detection of Urolithiasis: Diagnostic Performance and Dosimetry Compared With Digital Radiography With MDCT as the Reference Standard

American Journal of Roentgenology ◽

10.2214/ajr.09.3075 ◽

2010 ◽

Vol 195 (1) ◽

pp. 161-167 ◽

Cited By ~ 43

Author(s):

Koen Mermuys ◽

Frank De Geeter ◽

Klaus Bacher ◽

Kris Van De Moortele ◽

Kenneth Coenegrachts ◽

...

Keyword(s):

Digital Radiography ◽

Diagnostic Performance ◽

Digital Tomosynthesis ◽

Reference Standard

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Diagnostic performance of computed tomography and diffusion-weighted imaging as first-line imaging modality according to the International Myeloma Working Group (IMWG) imaging algorithm for monoclonal plasma cell disorders

Acta Radiologica ◽

10.1177/02841851211008383 ◽

2021 ◽

pp. 028418512110083

Author(s):

Min A Yoon ◽

Choong Guen Chee ◽

Hye Won Chung ◽

Dong Hyun Lee ◽

Kyung Won Kim

Keyword(s):

Plasma Cell ◽

Diffusion Weighted Imaging ◽

Diagnostic Performance ◽

Imaging Modality ◽

Reference Standard ◽

First Line ◽

Plasma Cell Disorders ◽

Misclassification Rates ◽

Line Imaging ◽

And Diffusion

Background The latest International Myeloma Working Group (IMWG) guideline recommends low-dose whole-body (WB) computed tomography (CT) as the first-line imaging technique for the initial diagnosis of plasma cell disorders. Purpose To evaluate diagnostic performances of CT and diffusion-weighted imaging (DWI) as the first-line imaging modalities and assess misclassification rates obtained following the guideline. Material and Methods Two independent radiologists analyzed CT (acquired as PET/CT) and DWI (3-T; b-values = 50 and 900 s/mm2) of patients newly diagnosed with plasma cell disorder, categorizing the number of bone lesions. Diagnostic performance of CT and DWI was compared using the McNemar test, and misclassification rates were calculated with a consensus WB-MRI reading as the reference standard. Differences in lesion number categories were assessed using marginal homogeneity and kappa statistics. Results Of 56 patients (36 men; mean age = 63.5 years), 39 had myeloma lesions. DWI showed slightly higher sensitivity for detecting myeloma lesions (97.4%) than CT (84.6%–92.3%; P > 0.05). CT showed significantly higher specificity (88.2%) than DWI (52.9%–58.8%; P<0.05). CT had a higher additional study requirement rate than DWI (7.7%–15.4% vs. 2.6%), but a lower unnecessary treatment rate (11.8% vs. 41.2%–47.1%). Both readers showed significant differences in categorization of the number of lesions on CT compared with the reference standard ( P < 0.001), and one reader showed a significant difference on DWI ( P = 0.006 and 0.098). Conclusion CT interpreted according to the IMWG guideline is a diagnostically effective first-line modality with relatively high sensitivity and specificity. DWI alone may not be an acceptable first-line imaging modality because of low specificity.

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Comparison of 2D Fat Suppressed Proton Density (FS-PD) and 3D (WATS-c) MRI pulse sequences in evaluation of chondromalacia patellae

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0102-z ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Ahmed Ibrahim Tawfik ◽

Wael Hamza Kamr ◽

Saher Ebrahim Taman

Keyword(s):

Diagnostic Performance ◽

False Negative ◽

Pulse Sequences ◽

Proton Density ◽

Grading System ◽

Reference Standard ◽

Mr Images ◽

Arthroscopic Findings ◽

Chondromalacia Patella ◽

Sensitivity Specificity

Abstract Background Comparing the diagnostic performance of widely used 2D FSE technique (fat-suppressed proton density; FS-PD) and the 3D technique (water-selective cartilage scan; WATS-c) in evaluation of the chondromalacia patella by using arthroscopy as reference standard Results Seventy-five adult patients were enrolled in this study. They underwent MRI examinations then arthroscopy done in 2–4 days after it. MRI was done using 2D (FS-PD) and 3D (WATS-c) sequences and MR images were compared by two radiologists separately, then grading of the cartilage lesions was performed according to modified Noyes grading system and comparison between grade 0–1, 2, and 3 lesions was done using arthroscopic findings as a reference. A false-negative result is considered if there was undergrading of chondromalacia and false-positive result if chondromalacia was overgraded. Each sequence sensitivity, specificity, and accuracy was calculated by both readers. For reader 1, the sensitivity is 69% for WATS-c and 80% for FS-PD and the accuracy is 90% for WATS-c and 92% for FS-PD and for reader 2, the sensitivity is 56% for WATS-c and 84% for FS-PD and the accuracy is 88% for WATS-c and 94% for FS-PD. Conclusion 2D FS-PD images showed better diagnostic performance than 3D WATS-c images for evaluating chondromalacia patella.

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Role of digital tomosynthesis in the context of tuberculosis contact investigation: comparisons with digital radiography

Acta Radiologica ◽

10.1177/02841851211022498 ◽

2021 ◽

pp. 028418512110224

Author(s):

Jeongha Mok ◽

Jeong A Yeom ◽

Su Won Nam ◽

Jun Mi Yoo ◽

Ji Won Lee ◽

...

Keyword(s):

Digital Radiography ◽

Low Dose ◽

Close Contact ◽

Correct Diagnosis ◽

Lower Sensitivity ◽

Digital Tomosynthesis ◽

Reference Standard ◽

Contact Investigation ◽

Screening Study ◽

Low Dose Computed Tomography

Background Chest radiography value as a screening tool in those exposed to pulmonary tuberculosis (TB) is reduced by its lower sensitivity to detect small intrapulmonary lesions. Purpose To evaluate the efficacy of digital tomosynthesis (DTS) screening of individuals that had contacted persons with active TB using low-dose computed tomography (CT) as the reference standard methods. Material and Methods This retrospective, community-based screening study of 90 adults who had been in close contact with a TB case was undertaken at our institution. All individuals underwent clinical evaluation, digital radiography (DR), DTS, and low-dose chest CT. Observers assessed and classified DR and DTS images using CT as the reference-standard method. Based on clinical and imaging findings, TB status was classified as normal, latent, minimal, subclinical, and active. Diagnostic performances of DTS and DR for the interpretation of correct diagnosis were calculated. Results The estimated effective doses for DR, DTS, and low-dose CT were 0.01 mSv, 0.1 mSv, and 0.33 mSv, respectively. TB statuses of the 90 individuals were as follows: 62 latent (68.9%); two subclinical (2.2%); and one minimal (1.1%). The sensitivities, specificities, and accuracies of DTS and DR in the interpretation of correct diagnosis were 75.8%, 100%, 91.1% and 48.5%, 96.5%, 78.9%, respectively. Conclusion DTS appears to be superior to DR for the detection of lung lesions in individuals with TB contacts. DTS can offer a reasonable option for TB contact investigation.

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TCT-708 Diagnostic Performance of Resting Distal to Aortic Coronary Pressure Using Instantaneous Wave-Free Ratio as a Reference Standard

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2017.09.946 ◽

2017 ◽

Vol 70 (18) ◽

pp. B303

Author(s):

Yuhei Kobayashi ◽

Nils Johnson ◽

Frederik Zimmermann ◽

Nils Witt ◽

Colin Berry ◽

...

Keyword(s):

Diagnostic Performance ◽

Reference Standard ◽

Coronary Pressure

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Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study

Scientific Reports ◽

10.1038/srep22365 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 31

Author(s):

Jana Podlipská ◽

Ali Guermazi ◽

Petri Lehenkari ◽

Jaakko Niinimäki ◽

Frank W. Roemer ◽

...

Keyword(s):

Articular Cartilage ◽

Knee Osteoarthritis ◽

Diagnostic Performance ◽

Structural Changes ◽

Morphological Changes ◽

Cost Effective ◽

Conventional Radiography ◽

Joint Space ◽

Meniscal Extrusion ◽

Knee Oa

Abstract Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.

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Diagnostic performance of cardiac imaging methods to diagnose ischaemia-causing coronary artery disease when directly compared with fractional flow reserve as a reference standard: a meta-analysis

European Heart Journal ◽

10.1093/eurheartj/ehw095 ◽

2016 ◽

pp. ehw095 ◽

Cited By ~ 19

Author(s):

Ibrahim Danad ◽

Jackie Szymonifka ◽

Jos W.R. Twisk ◽

Bjarne L. Norgaard ◽

Christopher K. Zarins ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Fractional Flow Reserve ◽

Cardiac Imaging ◽

Diagnostic Performance ◽

Meta Analysis ◽

Reference Standard ◽

Fractional Flow ◽

Flow Reserve ◽

Artery Disease

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Pulmonary Mycobacterial Disease: Diagnostic Performance of Low-Dose Digital Tomosynthesis as Compared with Chest Radiography

Radiology ◽

10.1148/radiol.10100303 ◽

2010 ◽

Vol 257 (1) ◽

pp. 269-277 ◽

Cited By ~ 55

Author(s):

Eun Young Kim ◽

Myung Jin Chung ◽

Ho Yun Lee ◽

Won-Jung Koh ◽

Hye Na Jung ◽

...

Keyword(s):

Chest Radiography ◽

Diagnostic Performance ◽

Low Dose ◽

Digital Tomosynthesis ◽

Mycobacterial Disease

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Correlation of dynamic contrast-enhanced bone perfusion with morphologic ultra-short echo time MR imaging in medication-related osteonecrosis of the jaw

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20210036 ◽

2021 ◽

pp. 20210036

Author(s):

Paul Schumann ◽

Sarah Morgenroth ◽

Florian A Huber ◽

Niels J Rupp ◽

Filippo Del Grande ◽

...

Keyword(s):

Diagnostic Performance ◽

Osteonecrosis Of The Jaw ◽

Reference Standard ◽

Characteristic Analysis ◽

Dce Mri ◽

Dynamic Contrast Enhanced ◽

Contrast Enhanced ◽

Echo Time ◽

Short Echo Time ◽

Mri Measurements

Objectives: To investigate whether dynamic contrast-enhanced (DCE)-MR bone perfusion could serve as surrogate for morphologic ultra-short echo time (UTE) bone images and to correlate perfusion with morphologic hallmarks in histologically proven foci of medication-related osteonecrosis of the jaw (MRONJ). Methods: Retrospective study including 20 patients with established diagnosis of MRONJ. Qualitative consensus assessment of predefined jaw regions by two radiologists was used as reference standard using Likert scale (0–3) for standard imaging hallmarks in MRONJ (osteolysis, sclerosis, periosteal thickening). DCE-MRI measurements performed in corresponding regions of the mandible were then correlated with qualitative scores. Regions were grouped into “non-affected” and “pathologic” based on binarized Likert scores of different imaging hallmarks (0–1 vs 2–3). DCE-MRI measurements among hallmarks were compared using Mann–Whitney-U-testing. ROC (receiver-operating-characteristic) analysis was performed for each of the perfusion parameters to assess diagnostic performance for identification of MRONJ using morphologic ratings as reference standard. Results: Median perfusion measurements of “pathologic” regions in wash-in, peak enhancement intensity and integrated area under the curve are significantly higher than those of “non-affected” regions, irrespective of reference imaging hallmark (p < 0.05). No significant perfusion differences were found between “pathologic” regions with and without osteolysis (p = 0.180). ROC analysis showed fair diagnostic performance of DCE-MRI parameters for identification of MRONJ (AUC 0.626–0.727). Conclusions: DCE bone perfusion parameters are significantly increased in MRONJ compared to non-affected regions, irrespective of osteolysis. Due to certain overlap DCE-MRI bone perfusion cannot serve as full surrogate for UTE bone imaging but may enhance reader confidence.

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