T2 Hypointensity Aids in the Diagnosis of Intracranial Metastatic Adenocarcinoma

ABSTRACT:Background:The T2 hypointensity has been suggested to be associated with intracranial metastatic adenocarcinomas (IMA). The purpose of our study was to determine the association of T2 hypointensity with IMA.Methods:All patients with pathologically confirmed metastatic brain tumors who had a magnetic resonance imaging (MRI) at our institution in the last 10 years were retrospectively assessed. Qualitative assessment of the lesions on MRI was done by two separate readers who were blinded to the pathological diagnosis. For qualitative assessment, the T2 hypointensity in the lesion was compared with the contralateral normal appearing white matter. Odds ratio, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.Results:Of 107 patients with intracranial metastasis, only 73 (40 females; 33 males; mean age 61 years) had MRI available for review. Of these, only 46 (25 females; 21 males; mean age 61 years) had pathologically proven IMA. T2 hypointensity was seen in 20% of IMA. The odds ratio of T2 hypointensity in IMA was 3 compared to nonadenocarcinomas but was not statistically significant (p = 0.16). Intralesional hemorrhage was seen in 20. When controlled for hemorrhage, the odds ratio for T2 hypointensity in IMA was 4.7. The specificity, sensitivity, PPV, and NPV for T2 hypointensity to diagnose IMA were 92%, 19%, 81%, and 40%, respectively.Conclusion:T2 hypointensity was seen only in 20% of IMA with an odds ratio of 4.7. T2 hypointensity showed a high specificity and PPV for diagnosis of IMA.

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Diffusion-Weighted Magnetic Resonance Imaging of Cholesteatoma Using PROPELLER at 1.5T: A Single-Centre Retrospective Study

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2016.05.002 ◽

2017 ◽

Vol 68 (2) ◽

pp. 116-121 ◽

Cited By ~ 3

Author(s):

Sharon E. Clarke ◽

Dipan Mistry ◽

Talal AlThubaiti ◽

M. Naeem Khan ◽

David Morris ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Retrospective Study ◽

Magnetic Resonance ◽

Predictive Value ◽

Resonance Imaging ◽

Predictive Values ◽

Second Look ◽

Diffusion Weighted ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.

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In Achilles Tendon Disorders, Will Sonoelastography Add to Grey-Scale Ultrasound? Using MRI as Gold Standard

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734224 ◽

2021 ◽

Author(s):

Nour Mohamed Kandil ◽

Maha Ahmed Abdelkarim ◽

Nagui Mohamed Abdelwahab ◽

Aya Mohamed Hashem

Keyword(s):

Achilles Tendon ◽

Predictive Value ◽

Gold Standard ◽

Ultrasound Examination ◽

High Specificity ◽

Resonance Imaging ◽

Diagnostic Ability ◽

Grey Scale ◽

Highly Sensitive ◽

Magnetic Resonance Imaging Mri

Abstract Background The aim of this study was to verify the findings of color-coded sonoelastography in Achilles tendon disorders against ultrasonographic and MR imaging findings, describing the elastographic patterns and correlating their diagnostic ability to magnetic resonance imaging (MRI) as a gold standard. Results Our study showed that sonoelastography appeared to be highly sensitive to ultrasonographically detected changes, with 100% sensitivity, 16.6% specificity, 73% positive predictive value, and 100% negative predictive value, making it a good negative test to exclude suspected tendinopathy in equivocal cases. MRI examination was used as a gold standard. Elastographic grades showed moderate agreement to those of MRI (κ = 0.44, p < 0.001), while elastography had overall sensitivity of 87.5%, 100% specificity, and 90% accuracy in differentiating normal and pathological tendons. Conclusion We concluded that sonoelastography is a sensitive method in the diagnosis of Achilles tendon pathologies detected by ultrasound examination and it can be well correlated to MRI with high specificity for pathological tendons.

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Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

American Journal of Sonography ◽

10.25259/ajs-22-2018 ◽

2018 ◽

Vol 1 ◽

pp. 9

Author(s):

Harshad Arvind Vanjare ◽

Jyoti Panwar

Keyword(s):

Rotator Cuff ◽

Negative Predictive Value ◽

Rotator Cuff Tear ◽

Predictive Value ◽

Rotator Cuff Tears ◽

Mri Findings ◽

Cuff Tear ◽

Experienced Operator ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

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A243 A RETROSPECTIVE REVIEW OF THE RADIOGRAPHIC DIAGNOSIS AND SURGICAL RESECTION RATES OF PANCREATIC SEROUS CYSTS

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.241 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 300-301

Author(s):

M Monachese ◽

S Li ◽

M Salim ◽

L Guimaraes ◽

P D James

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Surgical Resection ◽

Predictive Value ◽

Resected Specimen ◽

Cystic Lesions ◽

Resonance Imaging ◽

Guided Biopsy ◽

Magnetic Resonance Imaging Mri

Abstract Background Pancreatic cystic lesions are increasingly identified in persons undergoing abdominal imaging. Serous cystic neoplasms (SCNs) have a very low risk of malignant transformation. Resection of SCNs is not recommended in the absence of related symptoms. The accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) to identify SCNs is not known and may impact clinical care. Aims To evaluate the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis of SCN. To see how this can impact the decision to resect suspected SCNs. Methods Retrospective cohort study of patients from the University Health Network with suspected SCNs from 2017–2020 who underwent either a CT or MRI of the abdomen. Reports noting pancreatic cystic lesions were identified and reviewed. Only cases with suspected SCNs were included. Clinical (age, sex, symptoms, treatment) and radiographic (type of imaging, reported cyst characteristics) data was collected. Pathology was reviewed for all cases where the cysts was biopsied or resected during follow-up. The gold standard for the diagnosis for SCN was pathology of resected specimen or EUS-guided biopsy cytopathology showing no evidence of a mucinous lesion, CEA level below 10ug per L and amylase level below 50 U/L. Results 163 patients were included in the study. 99 (61%) were female and 98 (60%) underwent CT scan. EUS-guided biopsy was performed in 24 (15%) of patients and 8 (5%) had surgical resection. Multidisciplinary review was performed in 6 of the 8 cases that went to surgery. Of the resected specimens, 5 (63%) were SCN, 1 was a mucinous cystic lesion, 1 was a neuroendocrine tumor and 1 was a carcinoma. Two patients underwent EUS evaluation prior to surgical resection. In one case SCN was resected when EUS reported an undetermined cyst type. Reasons for surgical resection were: the diagnosis of serous cyst was not definitive (n=5), symptoms (n=2), and high-risk mucinous cystic neoplasm identified on EUS (n=1). Of 30 patients with pathology available, 15 (50%) were confirmed to have a SCN. CT and MRI had a sensitivity, specificity, positive predictive value and negative predictive value of 93%, 25%, 52% and 80%, respectively. Conclusions Surgical resection for SCN lesions is driven by diagnostic uncertainty after cross-sectional imaging. Multidisciplinary review and EUS evaluation may improve diagnostic accuracy and should be considered prior to surgical resection of possible SCN lesions. Funding Agencies None

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The slipping slipper sign: a simple test with high specificity and positive predictive value for peripheral neuropathy among diabetic patients

Clinics and Practice ◽

10.4081/cp.2012.e51 ◽

2012 ◽

Vol 2 (2) ◽

pp. 51 ◽

Cited By ~ 2

Author(s):

Krystal A.T. Gayle ◽

Marshall K. Tulloch-Reid ◽

Rainford J. Wilks ◽

Trevor S. Ferguson

Keyword(s):

Peripheral Neuropathy ◽

Positive Predictive Value ◽

Diabetic Neuropathy ◽

Predictive Value ◽

High Specificity ◽

Diabetic Patients ◽

Simple Test ◽

Diabetes Clinic ◽

Sensitivity Specificity ◽

Single Question

This study evaluated the ability of the slipping slipper sign (defined as unknowingly losing a slipper while walking) to identify diabetic neuropathy in Jamaican patients. A single question was used to ascertain the presence of the slipping slipper sign (SSS) among 69 patients attending a diabetes clinic. Nurses assessed pain, vibration and pressure perception among the same patients in order to detect diabetic neuropathy. The sensitivity, specificity and positive predictive value for the SSS were calculated. Eight participants (men=5, women=3) reported positive SSS. The SSS had a sensitivity of 28.6%, specificity of 100% and positive predictive value (PPV) 100% for neuropathy on at least one of the three tests. These findings indicate that the SSS has high specificity and PPV for diabetic neuropathy but the sensitivity is low. The sign may be a useful adjuvant to conventional methods of screening for severe neuropathy

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Clinical Performance of the Spot Vision Photo Screener before and after Induction of Cycloplegia in Children

Journal of Ophthalmology ◽

10.1155/2019/5329121 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Konuralp Yakar

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Clinical Performance ◽

High Specificity ◽

Screening Criteria ◽

Predictive Values ◽

Before And After ◽

Sensitivity Specificity ◽

Vision Screener

Aim. To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods. The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results. The Spot’s sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions. The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.

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MRI may be able to identify the origin of neuroendocrine tumor liver metastases

Neuroendocrinology ◽

10.1159/000513015 ◽

2020 ◽

Author(s):

Maxime Barat ◽

Philippe Soyer ◽

Fatima Al Sharhan ◽

Benoit Terris ◽

Ammar Oudjit ◽

...

Keyword(s):

Multivariate Analysis ◽

Neuroendocrine Tumors ◽

Interobserver Agreement ◽

Validation Cohort ◽

Univariate Analysis ◽

Intraclass Correlation ◽

Hepatic Metastases ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Objectives: To discriminate hepatic metastases from pancreatic neuroendocrine tumors (pNET) and hepatic metastases from midgut neuroendocrine tumors (mNET) with magnetic resonance imaging (MRI). Methods: MRI examinations of 24 patients with hepatic metastases from pNET were quantitatively and qualitatively assessed by two blinded readers and compared to those obtained in 23 patients with hepatic metastases from mNET. Inter-reader agreement was calculated with kappa and intraclass correlation coefficient (ICC). Sensitivity, specificity and accuracy of each variable for the diagnosis of hepatic metastasis from pNET were calculated. Associations between variables and primary tumor (i.e., pNET vs. mNET) were assessed at univariate and multivariate analysis. A nomogram was developed and validated using an external cohort of 20 patients with pNET and 20 patients with mNET. Results: Interobserver agreement was strong to perfect (k=0.893-1) for qualitative criteria and excellent for quantitative variables (ICC: 0.9817-0.9996). At univariate analysis, homogeneity on T1-weighted images was the most discriminating variable for the diagnosis of pNET (OR, 6.417; P=0.013) with greatest sensitivity (88%; 21/24; 95% CI: 68-97%). At multivariate analysis, tumor homogeneity on T1-weighted images (P=0.007; OR, 17.607; 95%CI: 2.179–142.295) and target sign on DW images (P=0.007; OR, 19.869; 95%CI: 2.305–171.276) were independently associated with pNET. Nomogram yielded a corrected AUC of 0.894 (95%CI: 0.796–0.992) for the diagnosis of pNET in the training cohort and 0.805 (95%CI: 0.662–0.948) in the validation cohort. Conclusions: MRI provides qualitative features that can help discriminate between hepatic metastases from pNET and those from mNET.

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Arthroscopic and Low-Field MRI (0.25 T) Evaluation of Meniscus and Ligaments of Painful Knee

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.96539 ◽

2012 ◽

Vol 2 ◽

pp. 24 ◽

Cited By ~ 5

Author(s):

Harish S Lokannavar ◽

Xiaochun Yang ◽

Harsha Guduru

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Imaging Study ◽

Cost Effective ◽

Non Invasive ◽

Low Field ◽

Cost Effective Technique ◽

Low Field Mri ◽

Magnetic Resonance Imaging Mri ◽

Sensitivity Specificity

Objective: Magnetic resonance imaging (MRI) is an accurate, non-invasive, cost-effective technique for examination of the soft tissue and osseous structures of the knee. The purpose of this study was to evaluate the accuracy of low-field MRI by comparing the results with subsequent arthroscopy. Materials and Methods: MR imaging study of 146 patients was done using 0.25 T ESTOATE G-SCAN and the sequence used were SE, FSE and GRE in all the three planes. The comparison was based on five parameters: accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. Result: Our study showed high accuracy (98.08%) and negative predictive value (98.62%) for MRI in comparison with arthroscopy. Conclusion: Low-field MRI alleviates the need of arthroscopy for detection of meniscus tears and ligament tears.

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Correlation of magnetic resonance imaging and post-ablation endoscopy to detect oesophageal thermal injury in patients after atrial fibrillation ablation: MRI-EDEL-study

EP Europace ◽

10.1093/europace/euaa081 ◽

2020 ◽

Vol 22 (7) ◽

pp. 1009-1016

Author(s):

Philipp Halbfass ◽

Lukas Lehmkuhl ◽

Borek Foldyna ◽

Artur Berkovitz ◽

Kai Sonne ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Atrial Fibrillation ◽

Magnetic Resonance ◽

Predictive Value ◽

Diagnostic Value ◽

Resonance Imaging ◽

Oesophageal Injury ◽

Mri Sequences ◽

Sensitivity Specificity ◽

Signal Intensities

Abstract Aims To correlate oesophageal magnetic resonance imaging (MRI) abnormalities with ablation-induced oesophageal injury detected in endoscopy. Methods and results Ablation-naïve patients with atrial fibrillation (AF), who underwent ablation using a contact force sensing irrigated radiofrequency ablation catheter, received a cardiac MRI on the day of ablation, and post-ablation oesophageal endoscopy (OE) 1 day after ablation. Two MRI expert readers recorded presence of abnormal oesophageal tissue signal intensities, defined as increased oesophageal signal in T2-fat-saturated (T2fs), short-tau inversion-recovery (STIR), or late gadolinium enhancement (LGE) sequences. Oesophageal endoscopy was performed by experienced operators. Finally, we correlated the presence of any affection with endoscopically detected oesophageal thermal lesions (EDEL). Among 50 consecutive patients (age 67 ± 7 years, 60% male), who received post-ablation MRI and OE, complete MRI data were available in 44 of 50 (88%) patients. In OE, 7 of 50 (14%) presented with EDEL (Category 1 lesion: erosion n = 3, Category 2 lesion: ulcer n = 4). Among those with EDEL, 6 of 7 (86%) patients presented with increased signal intensities in all three MRI sequences, while only 2 of 37 (5%) showed hyperintensities in all three MRI sequences and negative endoscopy. Correspondingly, sensitivity, specificity, positive predictive value, and negative predictive value (NPV) for MRI (increased signal in T2fs, STIR, and LGE) were 86%, 95%, 75%, and 97%, respectively. Conclusion Increased signal intensity in T2fs, STIR, and LGE represents independent markers of EDEL. In particular, the combination of all three has the highest diagnostic value. Hence, MRI may represent an accurate, non-invasive method to exclude acute oesophageal injury after AF ablation (NPV: 97%).

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Concordance Between Transcranial Magnetic Stimulation and Functional Magnetic Resonance Imaging (MRI) Derived Localization of Language in a Clinical Cohort

Journal of Child Neurology ◽

10.1177/0883073820901415 ◽

2020 ◽

Vol 35 (6) ◽

pp. 363-379

Author(s):

Katherine Schiller ◽

Asim F. Choudhri ◽

Tamekia Jones ◽

Christen Holder ◽

James W. Wheless ◽

...

Keyword(s):

Functional Mri ◽

Odds Ratio ◽

Magnetic Stimulation ◽

Diagnostic Odds Ratio ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Clinical Cohort ◽

Brodmann Areas ◽

Magnetic Resonance Imaging Mri ◽

Language Areas

Transcranial magnetic stimulation (TMS) is a newer noninvasive language mapping tool that is safe and well-tolerated by children. We examined the accuracy of TMS-derived language maps in a clinical cohort by comparing it against functional magnetic resonance imaging (MRI)–derived language map. The number of TMS-induced speech disruptions and the volume of activation during functional MRI tasks were localized to Brodmann areas for each modality in 40 patients with epilepsy or brain tumor. We examined the concordance between TMS- and functional MRI–derived language maps by deriving statistical performance metrics for TMS including sensitivity, specificity, accuracy, and diagnostic odds ratio. Brodmann areas 6, 44, and 9 in the frontal lobe and 22 and 40 in the temporal lobe were the most commonly identified language areas by both modalities. Overall accuracy of TMS compared to functional MRI in localizing language cortex was 71%, with a diagnostic odds ratio of 1.27 and higher sensitivity when identifying left hemisphere regions. TMS was more accurate in determining the dominant hemisphere for language with a diagnostic odds ratio of 6. This study is the first to examine the accuracy of the whole brain language map derived by TMS in the largest cohort examined to date. While this comparison against functional MRI confirmed that TMS reliably localizes cortical areas that are not essential for speech function, it demonstrated only slight concordance between TMS- and functional MRI–derived language areas. That the localization of specific language cortices by TMS demonstrated low accuracy reveals a potential need to use concordant tasks between the modalities and other avenues for further optimization of TMS parameters.

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